乳腺叶状肿瘤超声声像特征及弹性成像评分差异

Ultrasonographic charateristics and elastographic scores of phyllodes tumor of the breast

目的总结乳腺叶状肿瘤(phyllodes tumor of the breast, PTB)的超声声像特征及弹性成像评分差异。方法 38例PTB患者中,良性24例、恶性5例、交界性9例,记录其超声声像特征及弹性成像评分。结果超声声像示38例腋窝均未见肿大淋巴结;良性、交界性PTB肿瘤直径≥2.5 cm者多见,病灶边界多清晰,内部回声多均匀;良性、恶性PTB有囊性无回声区、高回声分隔多见;恶性PTB内部回声多不均匀,血流信号多丰富。弹性成像评分1、2、3、4、5分者,良性PTB分别有1、12、9、1、1例,交界性PTB分别有1、3、4、1、0例,恶性PTB分别有0、3、1、1、0例。超声弹性成像诊断良性PTB 34例,恶性PTB 4例,2例良性误诊为恶性,4例恶性误诊为良性,8例交界性误诊为良性,1例交界性误诊为恶性,判定PTB性质的准确率为60.53%(23/38)。结论不同病理类型PTB的超声声像特异性差,弹性成像鉴别诊断PTB性质的价值较低。

Objective To investigate the ultrasonographic charateristics and the difference of elastographic scores of the phyllodes tumor of the breast(PTB). Methods In 38 patients with PTB, 24 were benign, 5 were malignant and 9 were borderline. The ultrasonographic characteristics and elastographic scores were recorded. Results The metastases were absent in all axillary lymph nodes. Most of the benign and borderline PTBs were ≥2.5 cm in diameter, with clear lesions boundary and uniform internal echo. Benign and malignant PTBs were found cystic anechoic area and hyperechoic area septum.Malignant PTBs were commonly found uniform internal echo, with color Doppler signals of abundant blood flow.The elastographic score 1, 2, 3, 4 and 5 covered 1, 12, 9, 1 and 1 patient with benign PTB, 1, 3, 4, 1 and 0 patient with borderline PTB, and 0, 3, 1, 1 and 0 patient with malignant PTB, respectively.Elastography confirmed 34 benign PTBs, 4 malignant PTBs, 2 benign PTBs misdiagnosed as malignant ones, 4 malignant PTBs misdiagnosed as benign ones, with the accuracy rate of 60.53%(23/38). Conclusion The ultrasonographic charateristics are not specific in patients with different pathological types of PTB, and elastography has low value to the differential diagnosis of PTB.