彩色多普勒超声对乳腺包裹性乳头状癌的诊断价值

The value of color Doppler ultrasound in the diagnosis of breast encapsulated papillary carcinoma

目的:探讨彩色多普勒超声在乳腺包裹性乳头状癌中的诊断价值。方法:回顾性分析2016年5月—2021年5月于内蒙古科技大学包头医学院第一附属医院经手术病理证实的9例乳腺包裹性乳头状癌患者的二维、彩色多普勒声像学特征及临床表现。结果:9例乳腺包裹性乳头状癌,均为女性,年龄47~75岁,中位年龄67岁。病理诊断结果:5例病理为单纯型EPC,2例病理EPC伴导管原位癌,另2例病理EPC伴浸润。二维超声表现:囊实性肿块边界清晰,形态规则,后方回声轻度增强;实性肿块呈低回声,形态欠规则,边缘模糊,1例可见微钙化。彩色多普勒血流显示:4例囊实性肿块实性部分可见点或条状血流信号,2例实性肿块可见血流信号,其中1例血流信号丰富。脉冲多普勒血流显示:2例囊实性EPC及2例实性EPC可见动脉血流频谱,最大流速范围8~11 cm/s,阻力指数范围0.46~0.98。结论:乳腺包裹性乳头状癌超声表现多样,其典型的声像图特征为囊实性肿块,形态规则,边缘清晰,实性部分形态欠规,边缘模糊。当肿块形态不规则,边缘模糊不清,血流信号丰富,可见动脉血流频谱时,提示乳腺包裹性乳头状癌伴浸润可能性大。

Objective To investigate the value of color Doppler ultrasound in the diagnosis of encapsulated papillary carcinoma of the breast.Methods The two-dimensional and color Doppler sonographic features and clinical manifestations of 9 cases patients of breast encapsulated papillary carcinoma confirmed by surgery and pathology in the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology from May 2016 to may 2021 were analyzed retrospectively.Results Nine cases of encapsulated papillary carcinoma of the breast were all female,aged 47 to 75 years old,with a median age of 67 years.Pathological diagnosis:5 were pathologically simple EPC,2 were pathological EPC with ductal carcinoma in situ,and the other 2 were pathological EPC with infiltration.Two-dimensional ultrasound showed solid cystic masses had clear boundaries,regular morphology,and mildly enhanced posterior echo;solid masses were hypoechoic,irregular in shape and fuzzy edges,and 1 case showed microcalcification;Color Doppler flow imaging showed that 4 cases of solid cystic mass showed dot or strip blood flow signal,2 cases of solid mass showed blood flow signal,of which 1 case had abundant blood flow signal,pulse Doppler showed that 2 cases of solid EPC and 2 cases of solid EPC showed arterial blood flow spectrum,the maximum velocity range was 8 to 11cm/s,and the resistance index ranged from 0.46 to 0.98.1 case in this group was misdiagnosed as breast cyst with hemorrhage before operation.Conclusion The ultrasound manifestations of encapsulated papillary carcinoma of the breast are diverse.Its typical sonographic features are cystic solid masses with regular morphology and clear edges.The solid parts are irregular in shape and fuzzy edges.When the shape of the mass is irregular,the edges are blurred,the blood flow signal is abundant,and the arterial blood flow spectrum is visible,it indicates that the encapsulated papillary carcinoma of the breast is likely to be infiltrated.