高频彩色多谱勒超声对乳腺管内乳头状瘤的诊断价值

The value of high frequency color doppler ultrasound diagnosis for breast intraductal papilloma

目的 :研究高频彩色多普勒超声对乳腺管内乳头状瘤的诊断价值。方法 :50例手术病理证实的管内乳头状瘤 ,有乳头溢血、溢液 ,扪及肿块的临床症状 ,术前均经高频彩色多普勒超声检查 ,将探头直接在乳房表面作由乳头向四周的放射状扫查 ,发现扩张导管后在其内仔细查找病灶 ,观察其二维声像图和检测其彩色血流信号。结果 :高频彩色多普勒超声对管内乳头状瘤的检出率和诊断正确率分别为 62 .0 %、38.0 % ,明显优于钼靶摄影与近红外扫描。声像图分为四种类型 :无异常发现型 (7例 )、导管扩张伴肿瘤型 (1 9例 )、单纯导管扩张 (1 2例 )、单纯肿瘤型 (1 2例 ) ,其中导管扩张伴肿瘤型的声像图最为典型。肿瘤的彩色血流检出率较低 (5/ 50 )。结论 :高频彩色多普勒超声对乳腺管内乳头状瘤的诊断有一定的价值 ,特殊的临床症状、正确的检查方法和典型的声像图是超声诊断的关键。

Purpose:To study the value of high frequency color doppler ultrasound diagnosis for breast intraductal papilloma.Methods:50 patients with breast intraductal papilloma,all confirmed by surgical and pathology,and examined by ultrasound before surgery,all had symptoms of excreting blood or liquid from nipple or palpable mass. The probe were placed on the surface of the breast to scan radially from nipple,after finding the enlarged duct,try to detect the neoplasm in it carefully. The two dimensional images were observed and the color Doppler flow codes were detected.Results:The detection rate and the diagnostic accuracy rate of breast intraductal papilloma by ultrasound are 62.0% and 38.0% respectively,ultrasonography is better than mammography and near infrared light scanning.The images were divided into four types:one type of no unusual finding(7 cases),one type of finding both the enlarged duct and the tumor(19 cases),one type of finding the enlarged duct only(12 cases),one type of finding the tumor only(12 cases),the images of the type of finding both the enlarged duct and the tumor are typical. The detection rate of flow by color doppler ultrasound is low(5/50).Conclusions:The high frequency color doppler ultrasound is valuable in diagnosis of breast intraductal papilloma,and the special symptom ,the accurate detection method and the typical images are the key of ultrasound diagnosis.