乳腺非肿块型病变的超声表现及其与病理学结果的对比分析

Ultrasound manifestations and pathological results of non-mass breast lesions

目的分析乳腺非肿块型病变的超声表现及其与病理学结果的对比。方法回顾性分析2017年4月至2019年4月郑州人民医院收治的经病理学证实的60例乳腺非肿块型病变患者的临床资料,均经超声检查,并与病理结果进行对照。结果病理学结果显示,非恶性病变19例,恶性病变41例。60例乳腺非肿块型病变中,36超声表现为片状低回声,21例表现为含散在微钙化片状低回声区,4例表现为散在或簇状分布的微钙化区。超声诊断BI-RADS 3级病例占8.33%(5/60),4级病例占65.00%(39/60),5级病例占26.67%(16/60)。与组织病理学结果对照,超声诊断乳腺非肿块型病变的敏感性为92.68%,特异性为63.16%,准确性为75.00%。非恶性病变组腋下淋巴结异常比例(9/19)高于恶性病变组(9/41),P<0.05;两组病灶最大直径、微钙化情况及血流分布情况比较差异未见统计学意义(P>0.05)。结论超声诊断乳腺非肿块型病变的敏感性较高,以不含钙微化的片状低回声为主要表现,但在临床诊断中需结合其他方式,以减少误诊率。

Objective To analyze the ultrasound findings of non-mass breast lesions,and to compare them with pathological results.Methods The clinical data of 60 patients diagnosed as non-mass breast lesions by pathology who were admitted to Zhengzhou People’s Hospital from April 2017 to April 2019 were retrospectively analyzed.All the patients underwent ultrasound examination,and the examination results were compared with pathological results.Results Pathological results showed 19 cases with non-malignant lesions and 41 cases with malignant lesions.Of 60 cases with non-mass breast lesions,there were 36 cases with patch-like hypoecho by ultrasound,21 cases with scattered microcalcification-like hypoecho area,and 4 cases with scattered or clustered microcalcification area.Ultrasound diagnosis showed that 8.33%(5/60),65.00%(39/60)and 26.67%(16/60)of them with BI-RADS were grade 3,4 and 5,respectively.Compared with histopathological results,sensitivity,specificity and accuracy of ultrasound in diagnosing non-mass breast lesions were 92.68%,63.16%,and 75.00%,respectively.The rate of axillary lymph node abnormalities in non-malignant lesion group(9/19)was significantly higher than that in malignant lesion group(9/41),P<0.05.There was no significant difference in major diameters of lesions,microcalcification rate or blood flow distribution between the two groups(P>0.05).Conclusions The sensitivity of ultrasound in diagnosing non-mass breast lesions is relatively higher,which is mainly characterized with patch-like hypoecho without microcalcification.However,it is necessary to performe the other ultrasound methods,additionally,in clinical diagnosis to reduce misdiagnosis rate.