乳腺结节的超声声像图表现与病理结果的对比分析

Comparative Analysis of Ultrasound Sonography and Pathological Results of Breast Nodules

目的对超声检查结果为乳腺实质性结节的声像图与其术后病理结果进行比较,以提高乳腺超声检查对结节病理定性的准确率。方法采用回顾性分析方法,收集2017年1月~2018年12月在我院行乳腺超声检查发现结节并进行手术或穿刺活检的的226例患者的临床资料,对比乳腺超声检查结果与乳腺结节术后或穿刺活检的病理结果,分析超声检查准确率及误诊率情况。结果在226例患者共256个乳腺结节,超声提示乳腺BI-RADS2~4a类的良性结节206个,分别为乳腺增生结节98个、纤维腺瘤71个、肉芽肿性乳腺炎18个、导管内乳头状瘤12个、叶状肿瘤7个;BI-RADS分类在4b以上(高度怀疑恶性)的结节50个。经手术后病理或穿刺活检病理诊断证实,在超声提示的256个结节中,确诊良性结节有199个(其中乳腺增生结节9个、纤维腺瘤79个、肉芽肿性乳腺炎14个、导管内乳头状瘤10个、良性叶状肿瘤6个);恶性结节57个(其中浸润性导管癌24个、硬癌16个、黏液腺癌6个、髓样癌6个、大汗腺癌3个、恶性叶状肿瘤1个)。与病理结果比较,超声检查对乳腺良、恶性结节定性的符合率分别为96.6%、87.7%。结论超声检查对乳腺良、恶性结节定性的符合率较高,可重复性强且价廉,在临床治疗方案的制定中具有重要的参考价值。

Objective To compare the sonographic results of breast parenchymal nodules with the pathological results of postoperative ultrasound to improve the accuracy of breast nodule pathological characterization. Methods A retrospective analysis method was used to collect clinical data of 226 patients who underwent ultrasound or breast biopsy in our hospital from January 2017 to December 2018. The results of breast ultrasound were compared with those of the breast The pathological results after nodule or puncture biopsy were analyzed for the accuracy and misdiagnosis rate of ultrasound. Results There were 256 breast nodules in 226 patients. Ultrasound revealed 206 benign nodules of breast BI-RADS 2~4 a, including 98 breast hyperplasia nodules, 71 fibroadenomas, and granulomatous mastitis. There were 18 ductal papillomas and 7 phyllodes tumors;50 nodules with BI-RADS classification above 4 b(highly suspected malignancy). Postoperative pathology or biopsy confirmed the diagnosis. Among the 256 nodules suggested by ultrasound, 199 benign nodules were diagnosed(including 9 hyperplasia nodules, 79 fibroadenomas, and 14 granulomatous mastitis., 10 ductal papillomas, 6 benign phyllodes tumors;57 malignant nodules(including 24 invasive ductal carcinomas, 16 hard carcinomas, 6 mucinous adenocarcinomas, 6 medullary carcinomas, and sweating glands) 3 cancers and 1 malignant phyllodes tumor). Compared with pathological results, the coincidence rates of benign and malignant nodules in the breast were 96.6% and 87.7%, respectively. Conclusion Ultrasonography has a high qualitative coincidence rate of benign and malignant breast nodules, is highly reproducible and inexpensive, and has important reference value in the formulation of clinical treatment plans.