化生性乳腺癌的多模态超声特征

Multimodality ultrasonographic features of metaplastic breast carcinoma

目的探讨乳腺化生性癌不同超声模式下的影像表现特征。方法回顾性分析2005年1月～2017年5月在我院经手术病理证实的16例化生性乳腺癌的二维超声、彩色多普勒超声、超声弹性成像、三维冠状面超声特征。结果二维超声表现,16例均表现为肿块,其中形态不规则12例,形态规则4例;内部为低回声11例,混合回声5例;边缘不完整10例,边缘完整6例;内部伴有细小钙化8例,后方回声增强12例,同侧腋窝淋巴结肿大2例。彩色多普勒超声,血流分级IV级9例、III级3例、I～II级3例、0级1例;阻力指数0.51～0.88,62.50%的肿块血流阻力指数>0.7。超声弹性成像,弹性评分:3分2例,4分8例,5分4例。三维冠状面成像,8例肿块在冠状面上表现为"汇聚征",鳞状细胞癌中80.00%有"汇聚征"。结论乳腺化生性癌图像多表现为形态不规则、内部低回声或混合回声、边缘不完整、后方回声增强、血供丰富、弹性硬度高,三维冠状面的"汇聚征"有助于诊断。

Objective To investigate the multimodality ultrasound features of metaplastic breast carcinoma （MPBC）. Methods We retrospectively analyzed the features of two-dimensional ultrasound, color Doppler ultrasound, ultrasound elastography and three-dimensional coronal ultrasound of 16 patients with MPBC confirmed by pathology in our hospital from January 2005 to May 2017. Results Two-dimensional ultrasound showed that 16 cases were mass lesions, of which there were 12 cases of irregular shape, 4 cases of regular shape, 11 cases of hypoecho, 5 cases of mixed echo, 10 cases with incomplete edge, 6 cases with complete edge 8 cases accompanied by small calcification, 12 cases with posterior acoustic enhancement, 2 cases with enlargement of ipsilateral axillary lymph nodes. Color Doppler ultrasound showed that there were 9 cases of blood grade IV, 3 cases of grade III, 3 cases of grade I^II, and 1 case of grade 0. The resistance index was 0.51~0.88 and 62.50% of resistance index was 〉 0.7. The elasticity score by ultrasound elasticity imaging showed that 2 cases were 3 points, 8 cases were 4 points, and 4 cases were 5 points. Three-dimensional coronal plane imaging demonstrated that 8 cases showed “retraction phenomenon” and 80.00% of squamous cell carcinoma presented with the ＂convergence sign＂. Conclusion The features of MPBC were characterized by irregular shape, internal hypoecho or mixed echo, incomplete edge, the enhanced rear echo, abundant blood supply, and high elasticity. The ＂retraction phenomenon＂ in three-dimensional coronal plane could help the diagnosis.