乳腺导管原位癌的超声分型及其相关研究

Ultrasonographic classification of ductal carcinoma in situ of breast and its related research

目的:探讨乳腺导管原位癌不同超声分型的超声声像图及弹性特征,提高超声对乳腺导管原位癌的诊断价值。方法:回顾性分析2017年1月—2020年9月济宁医学院附属医院收治的112例乳腺导管原位癌患者的超声声像图特征,记录肿块大小、边界、内部回声、血供、导管扩张、钙化及淋巴结转移等,结合临床表现、乳腺钼靶检查、剪切波弹性成像及病理结果进行分析。结果:根据声像图特征,将乳腺导管原位癌分为5种类型:①实性肿块型40例(35.71%);②导管扩张型8例(7.14%);③低回声区型53例(47.32%);④囊实性肿块型6例(5.36%);⑤无超声表现型5例(4.47%)。所有病灶于溢液、钙化、血流、超声分级、病理结果及弹性模量最大值等方面在不同乳腺导管原位癌超声分型中的差异有统计学意义(P<0.05);在不同超声分型的DCIS弹性模量值中,弹性模量值的最大值(Emax)在各型差异有统计学意义,而平均值(Emean)、最小值(Emin)差异无统计学意义。结论:分析总结DCIS不同超声分型的临床特点、超声表现、病理特点及弹性特征,可在一定程度上提高超声对DCIS的诊断价值。

Objective To investigate the sonographic features and elastography of different types of breast ductal carcinoma in situ,and to improve the diagnostic value of ultrasound for breast ductal carcinoma in situ.Methods The ultrasonographic features of 112 patients with breast ductal carcinoma in situ treated in the Affiliated Hospital of Jining Medical College from January 2017 to September 2020 were analyzed retrospectively,and they were recorded of the size,boundary,internal echo,blood supply,catheter dilation,presence or absence of calcification,and lymph node metastasis,etc.Comprehensive analysis was performed in combination with clinical manifestations,mammography,shear wave elastography,and pathological results.Results According to the ultrasonic characteristics,the breast ductal carcinoma in situ was divided into five types:①40 cases(35.71%)of solid mass type;②8 cases(7.14%)of dilation duct type;③53 cases(47.32%)of hypoechoic area type;④6 cases(5.36%)of solid cyst type;⑤5 cases(4.47%)of no abnormal type.The discharge,calcification,blood flow,ultrasound grading,pathological findings and maximum value of elasticity were statistically significant in different types of ductal carcinoma in situ of breast(P<0.05).Among the DCIS elastic modulus values of different ultrasound types,the Emax of the elastic modulus value is statistically significant among the different types,and there is no significant difference in the Emean and Emin.Conclusion The analysis and summary of the clinical characteristics,ultrasound imaging,pathological characteristics and elastic characteristics of DCIS with different ultrasound types can improve the diagnostic value of DCIS to a certain extent.