乳腺慢性炎症的超声与钼靶X线表现比较

Comparative analysis on ultrasonic and mammographic characteristics of breast chronic infl ammation

目的比较乳腺慢性炎症的超声与钼靶X线检查表现。方法回顾性分析2006年1月至2012年12月福建医科大学附属协和医院经病理检查证实的20例乳腺慢性炎症的术前超声（20例）与X线（16例）检查结果，所有患者均为单发病灶。采用Fisher确切概率法比较乳腺慢性炎症病灶超声表现与钼靶X线表现差异及诊断符合率。结果超声检查示本组20个病灶纵横径比值平均为O．47±0．15；17个病灶形态不规则、边缘不清晰、不均质低回声；13个病灶后方回声增强：10个病灶血流0-I级，10个病灶血流Ⅱ～Ⅲ级。钼靶X线检查示病灶形态、边缘是否清晰、密度均质性等表现与超声表现较相似（P值分别为1．00、1．00、0．61）。超声检查发现5个病灶内点状强回声，但同时行X线检查均未见明确钙化灶；而X线检查发现1个病灶内散在钙化灶，超声检查漏诊。超声检查发现5例患者腋窝淋巴结肿大，而X线检查仅检出1例患者腋窝淋巴结增大。本组乳腺慢性炎症患者超声诊断符合率为40％（8／20），明显高于钼靶X线检查的6％（1／16），且差异有统计学意义（P=O．03）。结论乳腺慢性炎症具有一定的声像学特征，超声检查联合钼靶X线检查有助于乳腺良恶性病变的鉴别诊断。

Objective To compare the ultrasonic and mammographic appearances of breast chronic inflammation （BCI）. Methods The ultrasonic and mammographic features of 20 pathologically confirmed BCI cases were analyzed retrospectively. All cases were of single lesion. Fisher definite probability method was used to compare the differences between ultrasonic and mammographic appearances as well as the diagnostic coincidence rate. Results Under ultrasonography, the mean longitudinal diameter/transverse diameter （L/T） ratio of 20 lessions was calcultated as 0.47±0.15, 17 lesions were of irregular shape, unclear boundary and inhomogeneous hypoecho, 13 lesions were of posterior echo enhancement, the blood flow of 10 lesions belonged to 0- I , and the other 10 belonged to Ⅱ - Ⅲ. The lesion shape, boundary and homogeneity detected by mammography were coincident to those by ultrasonography （P=-1.00, 1.00, 0.61, respectively）. In 5 lesions, dotted high-echoes were detected by ultrasonography, however no calcification was found by mammography. Meanwhile, 1 lesion with sporadic calcification detected by mammography was missed by ultrasonography. Ultrasonography detected 5 cases with axillary lymphadenopathy, in which only 1 case was found by mammography. The diagnostic coincidence rate of ultrasonography was 40% （8/20）, which was obviously higher than 6% （1/16） by mammography （P=0.03）. Conclusion BCI possesses certain ultrasonographic characteristics, and ultrasonography combined with mammography will be helpful for the differential diagnosis of malignant and benign diseases.