乳腺导管内乳头状瘤超声诊断回顾性分析(1)
摘 要：目的 回顾性分析乳腺导管内乳头状瘤超声图像特点及误诊原因，提高诊断准确率。方法 回顾性分析我院经手术病理证实的50例乳腺导管内乳头状瘤患者的彩色多普勒超声图像特点，根据声像图特征分为5型，观察超声图像分型、血流信号分类及BI-RADS分类标准。结果 50例患者共65个病灶，37个病灶超声诊断与病理结果相符合，诊断准确率为56.92%。其中Ⅰ型：导管扩张伴导管内实性结节，19个病灶，2个误诊；Ⅱ型：导管扩张伴远端中断处实性团块，5个病灶，1个误诊；Ⅲ型：囊实性混合回声团块，15个病灶，5个误诊；Ⅳ型：实性团块而无导管扩张，24个病灶，19个误诊；Ⅴ型：单纯导管扩张，2个病灶，2个误诊。彩色血流信号结果：23个病灶表现为0级；19个病灶表现为Ⅰ级；10个病灶表现为Ⅱ级；13个病灶表现为Ⅲ级。BI-RADS分类结果：2类2个病灶；3类59个病灶；4A类3个病灶；4C类1个病灶。结论 乳腺导管内乳头状瘤的超声表现有多种类型，诊断时应结合临床表现，运用多种超声成像方法综合诊断，以便进一步提高诊断准确率。
关键词：乳腺；导管内乳头状瘤；超声检查
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中图分类号：R737.9 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.23.045
文章编号：1006-1959(2018)23-0155-04
Abstract：Objective To retrospectively analyze the ultrasonographic features and misdiagnosis reasons of intraductal papilloma of mammary gland and improve the diagnostic accuracy. Methods The color doppler ultrasonographic features of intraductal papilloma of mammary gland in 50 patients confirmed by surgery and pathology in our hospital were retrospectively analyzed. According to the ultrasonographic features， they were divided into 5 types， and the ultrasonic image classification， blood flow signal classification and BI-RADS classification criteria were observed. Results There were 65 lesions in 50 patients， 37 lesions were diagnosed by ultrasound in accordance with pathological results， and the diagnostic accuracy was 56.92%. The Ⅰ type： duct expansion with intraductal solid nodules， 19 lesions， 2 misdiagnosis； Ⅱ type： distal catheter with intermitting position or solid mass，5 lesions， 1 misdiagnosis； Ⅲ type： cystic or solid mixed echo conglomeration， 15 lesions， 5 misdiagnosed； Ⅳ type： solid mass without duct expansion， 24 lesions， 19 misdiagnosed； Ⅴ type： pure duct expansion， and 2 lesions， 2 misdiagnosis. Color blood flow signal results： 23 lesions showed grade 0； 19 lesions characterized by Ⅰ level； 10 lesions characterized by Ⅱ level； 13 lesions characterized by Ⅲ level. BI-RADS classification results： 2 categories and 2 lesions； 59 lesions in 3 categories； category 4A： 3 lesions； category 4C： 1 lesion. Conclusion There are many types of ultrasound findings of intraductal papilloma of the breast. The diagnosis should be combined with clinical manifestations， and a variety of ultrasound imaging methods should be used for comprehensive diagnosis to further improve the diagnostic accuracy.
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Key words：Mammary gland；Intraductal papilloma；Ultrasonography
乳腺导管内乳头状瘤(intraductal papilloma，IDP)是一种乳腺良性肿瘤，单发多见，具有一定的恶变倾向，恶变率约5%[1]。导管内乳头状瘤体积较小，临床往往难以扪及，超声作为一种无创、易行的检查方法，在乳腺疾病诊断中具有重要价值。近年来，高频探头的使用大大提高了乳腺导管内乳头状瘤的检出率。本文回顾性分析我院50例经手术病理证实的乳腺导管内乳頭状瘤的声像图特征，并应用影像学报告及数据系统(breast imaging reporting and data system，BI-RADS)分级标准进行超声分级诊断，进一步提高IDP的诊断准确率。, http://www.100md.com(宋旭光 许华宁 何玉冰)
关键词：乳腺；导管内乳头状瘤；超声检查
, http://www.100md.com
中图分类号：R737.9 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.23.045
文章编号：1006-1959(2018)23-0155-04
Abstract：Objective To retrospectively analyze the ultrasonographic features and misdiagnosis reasons of intraductal papilloma of mammary gland and improve the diagnostic accuracy. Methods The color doppler ultrasonographic features of intraductal papilloma of mammary gland in 50 patients confirmed by surgery and pathology in our hospital were retrospectively analyzed. According to the ultrasonographic features， they were divided into 5 types， and the ultrasonic image classification， blood flow signal classification and BI-RADS classification criteria were observed. Results There were 65 lesions in 50 patients， 37 lesions were diagnosed by ultrasound in accordance with pathological results， and the diagnostic accuracy was 56.92%. The Ⅰ type： duct expansion with intraductal solid nodules， 19 lesions， 2 misdiagnosis； Ⅱ type： distal catheter with intermitting position or solid mass，5 lesions， 1 misdiagnosis； Ⅲ type： cystic or solid mixed echo conglomeration， 15 lesions， 5 misdiagnosed； Ⅳ type： solid mass without duct expansion， 24 lesions， 19 misdiagnosed； Ⅴ type： pure duct expansion， and 2 lesions， 2 misdiagnosis. Color blood flow signal results： 23 lesions showed grade 0； 19 lesions characterized by Ⅰ level； 10 lesions characterized by Ⅱ level； 13 lesions characterized by Ⅲ level. BI-RADS classification results： 2 categories and 2 lesions； 59 lesions in 3 categories； category 4A： 3 lesions； category 4C： 1 lesion. Conclusion There are many types of ultrasound findings of intraductal papilloma of the breast. The diagnosis should be combined with clinical manifestations， and a variety of ultrasound imaging methods should be used for comprehensive diagnosis to further improve the diagnostic accuracy.
, http://www.100md.com
Key words：Mammary gland；Intraductal papilloma；Ultrasonography
乳腺导管内乳头状瘤(intraductal papilloma，IDP)是一种乳腺良性肿瘤，单发多见，具有一定的恶变倾向，恶变率约5%[1]。导管内乳头状瘤体积较小，临床往往难以扪及，超声作为一种无创、易行的检查方法，在乳腺疾病诊断中具有重要价值。近年来，高频探头的使用大大提高了乳腺导管内乳头状瘤的检出率。本文回顾性分析我院50例经手术病理证实的乳腺导管内乳頭状瘤的声像图特征，并应用影像学报告及数据系统(breast imaging reporting and data system，BI-RADS)分级标准进行超声分级诊断，进一步提高IDP的诊断准确率。, http://www.100md.com(宋旭光 许华宁 何玉冰)