彩色多普勒超声对乳腺肿块的诊断

The Diagnostic of Color Doppler Ultrasound for Breast Lumps

目的:探讨彩色多普勒超声对乳腺良恶性肿块的诊断。方法:本组患者共36例,均经手术及病理证实,全部为笔者所在医院2008年1月-2012年1月住院确诊的女性患者,使用百胜MyLab15型彩色多普勒超声仪,观察肿块的部位、形态是否规整、大小、边界、内部回声、后壁同声、纵横比、有无周围组织浸润及腋窝淋巴结肿大等,应用彩色多普勒(CDFI)观察血流Adler分级并测量阻力指数(RI)。结果:良性肿块共32例,经术后病理证实,纤维腺瘤28例,乳腺增生性肿块4例;恶性肿块4例,经术后病理证实浸润性导管癌2例,小叶癌1例,原位癌1例。32例乳腺良性肿块的二维声像图多的表现为形态规则,边界清晰,内部回声均匀,大部分未见钙化,部分见颗粒状或弧形钙化,后方回声无衰减。乳腺恶性肿块二维声像图多表现为边界不清晰,模糊,呈"毛玻璃"样边缘,尤以"蟹足样"或"毛刺样"为典型,内部回声多不均匀,大部分有微小钙化。32例良性肿块中50%检出血流信号,Adler分级以0～1级为主(共15例),RI值0.57±0.25,而4例恶性肿块全部检出血流信号,Adler分级2级1例,3级3例,RI值为0.81±0.03。结论:应用彩色多普勒超声二维图像结合血流动力学检测对鉴别乳腺肿块良恶性具有重要的价值,为乳腺肿块的临床早发现、早诊断、早治疗提供了有利的参考依据。

Objective： To investigate the value of color Doppler ultrasound in the diagnosis of benign and malignant breast lumps.Methods： The patients of 36 cases were confirmed by surgery and pathology, all female patients hospitalized in our hospital from January 2008 to January 2012 confirmed use the Yum MyLab15 type color Doppler ultrasound to observe mass site regular, shape, size, border, internal echo, posterior wall simultaneous aspect ratio, whether the infiltration of the surrounding tissue and axillary lymph nodes and color Doppler （CDFI） observed blood flow Adler grading and measure resistance index （RI）. Results： The benign tumor of 32 cases of pathologically confirmed 28 cases of fibroadenoma, proliferative breast lumps 4 cases, 4 cases of malignant lumps, after two cases of pathologically confirmed invasive ductal carcinoma, lobular carcinoma, the original bit carcinoma.32 cases of benign breast lumps two-dimensional sonogram performance of morphological roles, clear boundary, internal echo uniform, most no calcification, partly to see of granular or curved calcification, posterior echo without attenuation.Malignant breast lumps multi-dimensional sonographic boundary was not clear, fuzzy, was “ground glass” like edge, especially in the “Crab-like” or “burr-like” typical inhomogeneous internal echo most of microcalcifications.50% of the 32 cases of benign lumps detected flow signals Adler classification mainly 0-1 grade （15 cases）, the RI value of 0.57±0.25, and 4 cases of malignant lumps all detected flow signals, Adler classification two cases, three cases, RI value of 0.81 ± O.03.Concluslon： The application of color Doppler ultrasound two-dimensional image combines with hemodynamic detection has important value to identify breast lumps benign and malignant, clinical breast lumps early detection, early diagnosis, early treatment and provide a favorable reference.