乳腺增生中浸润性导管癌的高频彩超诊断与鉴别

Identification and differentiation of infitrating ductal carcinoma in breast hyperplasia with high-frequency color Doppler ultrasonography

目的研究乳腺增生病灶中浸润性导管癌的超声诊断和鉴别。方法回顾分析临床及病理确诊的76例乳腺增生合并浸润性导管癌病灶的高频超声表现并作对比分析研究。结果乳腺增生合并浸润性导管癌超声表现具备多样性,主要以低回声团块、斑块和导管内隆起状结节表现为主,早期浸润性导管癌的特点是肿块侧方向导管走行区延伸或/和导管内隆起性小结节。本组超声检出实性肿块、斑块和微小结节共64例73个病灶,其中47例54个病灶超声提示为导管有关恶性肿瘤,12例14个肿块误诊为乳腺癌;5例5个导管内单发微小结节误诊为良性病灶或导管瘤。漏诊12例。本组病例乳腺浸润性导管癌阳性率为84.21%(64/76例),准确诊断率为73.97%(54/73例),误诊率26.03%(19/73例),漏诊率15.79%(12/76例)。超声全部诊断有乳腺增生与病理和临床诊断符合。结论乳腺增生合并浸润性导管癌临床常见,浸润性导管癌容易被乳腺增生掩盖,早期发现和确诊具有重要价值。本组总结其特征表现和诊断理论,为浸润性导管癌的超声诊断、早期发现和鉴别提供理论和应用帮助。

Objective To study the sonographic identification and authentication of infiltrating ductal carcinoma in breast hyperplasia lesions. Methods Retrospective analysis of clinical and pathological diagnosis in 76 cases of breast hy- perplasia complicated with invasive ductal carcinoma with loci of high frequency ultrasound and contrast analysis. Results Breast hyperplasia lesions with invasive ductal carcinoma with diversity, mainly with low echo mass, plaque and intra- ductal eminence nodule. Early invasive ductal carcinoma is characterized by mass in the lateral direction of the catheter walking area extending or / and intraductal eminence nodule. The detectable solid mass, plaques and nodules a total of 64 patients with 73 lesions, including 47 cases of 54 lesions of ultrasound with catheter tip of malignant tumor, 12 cases of 14 tumors misdiagnosed as breast cancer~ 5 cases of 5 catheter in solitary nodules misdiagnosed as benign lesions or ductal aneurysm. Misdiagnosis of 12 cases. This group of cases of invasive ductal carcinoma of the breast positive rate was 84. 21% （ 64/76 ）, accurate diagnosis rate was 73. 97% （ 54/73 ）, the misdiagnosis rate was 26.03% （ 19/73 ）, the missed diagnosis rate of 15.79 % （ 12/76 ）. Ultrasound diagnosis of breast hyperplasia with all the pathological and clini- cal diagnosis. Conclusions Hyperplasia of mammary glands with infiltrating ductal carcinoma of clinical common, infil- trating ductal carcinoma of breast hyperplasia cover is easy, early detection and diagnosis has important value. Summarize the features and diagnosis theory for invasive ductal carcinoma, ultrasound diagnosis, early detection and discrimination of the theory and application of help.