乳腺导管内原位癌的超声表现

Ultrasonographic performances of breast ductal carcinoma in situ

目的探讨乳腺导管内原位癌(DICS)的超声声像图表现和诊断价值。方法根据超声乳腺影像报告和数据系统标准(BI-RIDS),回顾性分析经病理确诊的50例DICS的超声表现。结果 50例DICS中,超声诊断符合率为74%,超声图像分为4个类型:Ⅰ型肿块伴钙化21例(42%);Ⅱ型单纯肿块24例(48%);Ⅲ型非肿块4例(8%)和Ⅳ型超声无阳性发现1例(2%),Ⅰ型、Ⅱ型、Ⅲ型诊断符合率分别为100%、54%、75%,Ⅰ型诊断的符合率明显高于Ⅱ型(x^2=12.739,P<0.005),Ⅰ型和Ⅲ型(P=0.160)、Ⅱ型和Ⅲ型(P=0.613)使用Fisher确切概率法,差异无统计学意义。结论肿块为DICS最多见的超声改变,超声对肿块伴钙化的DICS诊断效果好,对单纯肿块型有部分误诊,必须结合其他影像检查,超声在临床诊断DCIS中有较高价值。

Objective Explore the ultrasonographic performances and diagnostic value of the breast ductal carcinoma in situ(DICS).Methods According to the ultrasonic breast imaging report and the data system standard(BI-RIDS),retrospective analysis of 50 patients ultrasound images with pathological confirmed as DICS.Results In 50 cases,Ultrasound diagnosis coincidence rate was 74%,All cases images were classified into four categories:TypeⅠ21 cases of mass with calcification(42%).TypeⅡ24 cases of simple mass(48%);TypeⅢ4 cases Non-mass(8%)and TypeⅣ1 case no positive finding by ultrasound(2%).The coincidence rates of typeⅠ,typeⅡand typeⅢdiagnosis were 100%,54%and 75%respectively.The coincidence rate of typeⅠdiagnosis is significantly higher than that of typeⅡ(c2=12.739,P<0.005),Using Fisher’s exact test on typeⅠand typeⅢ(P=0.160)&typeⅡand typeⅢ(P=0.613),the difference was not statistically significant.Conclusion Mass are the most common ultrasonic finding,ultrasound on the mass with calcification of DICS diagnostic effect is good,some misdiagnosis of simple mass type,must be combined with other imaging,Ultrasound plays an important role in the clinical diagnosis ductal carcinoma in situ in the breast.