乳腺错构瘤分型的超声表现及病理特征研究

Study on Ultrasonic Manifestations and Pathological Features of Breast Hamartoma Classification

目的:探讨乳腺错构瘤各型的超声声像图特征及其与病理的关系,旨在提高本病的术前诊断准确率。方法:回顾性分析经手术和病理证实的24例乳腺错构瘤的超声影像资料,并分析其与病理相关性。结果:超声检出全部24例患者病灶,均为单发,以椭圆形或类圆形为主,边界清晰,内部为高回声、混合回声或低回声,伴或不伴线样分隔,均为乏血供病灶。本组病例依据瘤体内部所含脂肪和纤维腺体成分比例不同,超声声像图分为三型,其中脂肪型13例,病理镜下以脂肪成份为主;混合型9例,病理镜下脂肪与纤维腺体成份比例大致相等;致密型2例,病理镜下以纤维腺体成份为主。结论:各型乳腺错构瘤超声声像图特征与病理相关性良好,其中混合型与脂肪型错构瘤超声具有特征性改变,超声作为首选检查方法可基本明确诊断;致密型错构瘤声像图缺乏特征性改变,易与其他良性肿瘤混淆,明确诊断需依赖大体标本病理。

Objective:This study was aimed to explore the ultrasonographic characteristics of subtypes of breast hamartoma and their associations with pathology, in order to improve the diagnostic accuracy of this disease preoperatively.Methods:Retrospectively analyzed the ultrasound imaging datasets of 24 cases of breast hamartoma which were confirmed by surgery and pathology, and analyzed its correlation with pathology.Results:The lesions in all 24 patients were detected by ultrasound, all of which were single. The lesions mainly performed oval or round-shaped with clear borders, internal hyperechoic, mixed-echo or hypoechoic with or without linear separations. All the lesions lacked blood supply. According to the different ratios of fat or fibroglandular components, the ultrasound images of breast hamartoma were divided into three types, the fat type with fat components mainly under pathological microscope(n=13), the mixed type with the roughly equal proportion of fat and fibroglandular components(n=9) and the compact type with fibroglandular components mainly.Conclusion:Ultrasonographic features of breast hamartoma subtypes have a good correlation with pathology. The mixed and fatty hamartomas have specific characteristics in ultrasound images. Ultrasound is the first-line method of examination. Additionally, breast hamartoma can be fundamentally diagnosed by ultrasonography. The compact hamartoma lacks characteristic changes and is easily confused with other benign tumors. A clear diagnosis depends on the pathology of the gross specimen.