乳腺化生性癌的灰阶、彩色及弹性超声表现

Imaging Features of Metaplastic Breast Carcinoma by Grayscale Ultrasound,Color Doppler Ultrasound and Ultrasound Elastography

目的:探讨乳腺化生性癌的灰阶、彩色及弹性超声图像特点。方法:回顾分析20例经病理证实的乳腺化生性癌的超声图像资料。结果:20例患者共20个肿块,18个肿块呈低回声,2个呈中等回声;10个肿块回声不均匀,10个回声均匀;13个肿块形态不规则,4个呈卵圆形,3个呈分叶状。15个肿块边界清晰,5个边界模糊。6个肿块内见钙化,9个肿块内见无回声区;18个肿块后方回声增强,1个后方回声不变,1个后方回声轻度衰减。14个肿块血流丰富,4个见中等血流,2个未见血流;血流平均阻力指数0.77。4个肿块行弹性超声检查,弹性评分结果:3分1个,4分3个。乳腺肿块超声诊断符合率为85%(17/20)。同侧腋窝淋巴结超声诊断符合率为75%(3/4)。结论:乳腺化生性癌的超声图像多为不规则形,后方回声增强,可见囊实性及细小钙化灶,血流丰富,弹性超声评分高,灰阶超声、彩色超声及弹性超声的联合应用有助于病变的定性诊断。

Objective ：To investigate the imaging features of metaplastic breast carcinoma by grayscale ultrasound , color Doppler ultrasound and ultrasound elastography .Methods ：Imaging data of metaplastic breast carcinoma of twenty cases proved by pathology were retrospectively analyzed .Results ：There were eighteen masses with hypoecho and 2 masses with medium echo .Ten masses showed heterogeneous echo and the other ten showed homogeneous echo .The shape was irregular in 13 masses ,oval in 4 masses and microlobulated in 3 masses .The margin was circumscribed in 15 masses and indistinct in 5 masses .Microcalcifications were found in 6 masses .Echo free space was found in 9 masses .There were 18 cases with posterior acoustic enhancement , one case with invariable posterior echo and one case with posterior attenuation . Hypervascular , isovascular ,and avascular masses were found in 14 ,4 ,and 2 cases ,respectively .The mean resistance index was 0 .77 .Four masses were examined by ultrasound elastography .One mass was scored as 3 and 3 masses were scored as 4 .The accuracy rate of ultrasonic diagnosis for breast mass was 85% （17/20） .And the accuracy rate of ultrasonic diagnosis for ipsilateral axillary lymph nodes was 75% （3/4） .Conclusions ：Irregular shape ,posterior acoustic enhancement ,cystic spaces ,microcalcifications , hypervascular mass and high elastography score are the most frequent ultrasonic features for metaplastic breast carcinoma .The combination application of grayscale ultrasound ,color Doppler ultrasound and ultrasound elastography may be conducive to the etiologic diagnosis of lesion .