彩色多普勒超声检查对女性乳腺恶性病变的诊断价值

Diagnostic value of color Doppler ultrasound in female breast malignant lesions

目的分析乳腺病变彩色多普勒超声特征,比较良恶性乳腺病变的差异。方法选择2012-2016年间在东莞市万江医院接受超声检查的182例乳腺病变患者为研究对象,根据其病理结果分为良性组(137例)及恶性组(45例)。比较两组受检者的年龄、家族史、月经史、生育哺乳史等一般资料,并比较良、恶性组病灶彩色多普勒超声特征,包括病灶大小、位置、形态、边缘、内部回声、后方回声有无衰减、纵横(L/T)比、有无点状钙化、病灶内部及周边血流速度峰值(Vmax)、搏动指数(PI)、阻力指数(RI)及血流分级。结果恶性组与良性组患者的年龄[(50.1±8.5)岁vs (46.5±9.1)岁],有乳腺癌家族史的比例(20.0%vs 8.03%)、哺乳<6个月的比例(37.8%vs 13.9%)比较,恶性组患者年龄更大,有乳腺癌家族史的比例更高,哺乳<6个月的比例更高,差异均有统计学意义(P<0.05);恶性组与良性组患者病变形态不规则比例(77.8%vs 41.6%)、边缘不清比例(86.7%vs 48.2%)、后方衰减比例(62.2%vs35.8%)、回声不均比例(82.2%vs 37.2%)、L/T>1比例(68.9%vs 31.4%)、有点状钙化的比例(42.2%vs 16.8%)比较,恶性组均明显高于良性组,差异均具有统计学意义(P<0.05);恶性组与良性组患者PSV [(15.8±5.9) cm/s vs (8.7±3.1) cm/s]、PI(1.2±0.4 vs 1.0±0.3)、RI (0.8±0.3 vs 0.6±0.2)比较,恶性组均明显高于良性组,差异均有统计学意义(P<0.05);两组患者的血流分级间比较,差异有统计学意义(P<0.05)。结论乳腺恶性病变具有较典型的超声特征,通过形态学特征及多普勒血流动力学特征能够对乳腺恶性病变及乳腺良性病变进行鉴别。

Objective To analyze the characteristics of color Doppler ultrasound in breast lesions, and to compare the difference between benign and malignant breast lesions. Methods A total of 182 patients who underwent ultrasound screening in Dongguan Wanjiang Hospital from 2012 to 2016 were selected as the study subjects. According to their pathological results, 137 patients were benign(137 cases) and 45 patients were malignant(45 cases). The general data of age, family history, menstrual history, birth, and lactation history were compared between the two groups. The color Doppler ultrasound features of benign and malignant lesions were compared, including lesion size, location, shape,edge, internal echo, posterior echo attenuation, L/T ratio, punctate calcification, peak blood flow velocity(Vmax), pulsation index(PI), resistance index(RI), and blood flow grading. Results Compared with patients in benign group, the patients in malignant group had older age, higher proportion of family history of breast cancer, and higher proportion of breast-feeding:(50.1±8.5) years vs(46.5±9.1) years, 20.0% vs 8.03%, 37.8% vs 13.9%, all with statistically significant differences(P<0.05). The patients in malignant group had higher proportions of irregular lesions(77.8% vs 41.6%), unclear margins(86.7% vs 48.2%), posterior attenuation(62.2% vs 35.8%), uneven echoes(82.2% vs 37.2%), vertical and horizontal(L/T)>1(68.9% vs 31.4%), and slightly calcified(42.2% vs 16.8%), all with statistically significant difference(P<0.05). The PSV, PI, RI levels of malignant group were significantly higher:(15.8±5.9) cm/s vs(8.7±3.1) cm/s,(1.2±0.40) vs(1.0±0.3),(0.8±0.3) vs(0.6±0.2), all P<0.05. There was a significant difference in blood flow grading between the two groups(P<0.05). Conclusion Malignant breast lesions have typical ultrasonographic features and can be differentiated from benign breast lesions by morphological and Doppler hemodynamic characteristics.