彩超鉴别诊断乳腺良恶性肿块的临床价值

Differential diagnosis of benign and malignant breast ultrasound clinical value of tumor

目的 探讨应用彩超鉴别乳腺良恶性肿块的临床价值.方法 2011年6月～2013年6月于我院经手术或穿刺病理证实的乳腺良恶性肿块60例.使用美国西门子S-2000彩色多普勒超声诊断仪,先做二维超声观察病灶的位置、形态、大小、边界、内部回声、后方回声及有无钙化等,然后用彩色多普勒血流成像（CDFI）探测病灶内部及周边的血流信号.比较良恶性肿块的收缩期峰值速度（Vmax）、阻力指数（RI）.结果良性肿块二维超声的声像图以低回声为主,形态较规整,边缘光滑、整齐,有少量条状、片状、点状钙化,肿块周边及内部血流信号丰富度低.RI=0.58±0.31.血流分级主为0～I级,占85.4%.Vmax=9.12±1.53 cm/s.恶性肿块形态不规则,内部回声不均匀,内含液性暗区,微小钙化点多见.无包膜,后方回声衰减,呈毛刺样或蟹足样改变.肿块周围及内部可见多条动静脉彩色血流信号,Alder分级以Ⅱ级～Ⅲ级为主,占91.7%.RI=0.82±0.03.Vmax=17.34±3.65 cm/s.良、恶性肿块的Vmax及RI值比较有显著性差异（P〈0.05）.结论 彩色多普勒超声在鉴别乳腺良恶性肿块方面具有重要价值,为乳腺疾病的诊断及治疗提供了有利的指导依据.

Objective To investigate the application value of ultrasound diagnosis for benign and malignant breast tumor. Methods Sixty cases of benign and malignant breast tumors were checked by ultrasound. Used the Siemens S- 2000U.S. color Doppler ultrasound, observed the two-dimensional ultrasound lesion location, shape, size, border, internal echo, posterior echo and the presence of calcification, and color Doppler flow imaging（CDFI） detected lesions within and surrounding blood flow.The benign and malignant tumors of the peak systolic velocity （Vmax）, resistance index （RI） were compared. Results Benign lumps dimensional ultrasound sonogram to hypoechoic ,compared with regular shape,smooth edges,clean,a small amount of strip, sheet,punctate calcification, and internal flow signals around the tumor abundance was low. RI=0.58±0.31 ,showed a small amount of blood flow or no flow signal. Benign tumor group flow grade mainly for 0-1 grade, accounted 85.4%.Vmax=9.12± 1.53 em/s.Malignant tumor irregular, heterogeneous in- ternal echo,containing liquid dark area,microcalcifications common.No capsule ,posterior echo attenuation,burr-like or Crab-like changes.Around the lump and internal multiple arteriovenous visible color flow signals,multi-arterial tumor penetration inside;Tumor blood flow to the number of Alder grade II-III grade level flow signals,accounted 91.7%. Artery flow spectrum measured values：RI=0.82 ±0.03.Vmax 17.34±_3.65 cuds.Benign and malignant tumors of the Vmax and RI values were significantly different（P〈0.05）. Conclusion Color Doppler ultrasound using two-dimensional images combined with color Doppler hemodynamics and indirect signs analysis diagnosis in differentiating benign and malignant tumors and has a significant value.