高频彩超对乳腺良恶性肿块的鉴别诊断价值(1)

http://www.100md.com 2010年6月5日 叶长空

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     [摘要] 目的:探讨高频彩超对乳腺良恶性肿块的诊断及鉴别诊断价值。方法:对236例经手术病理证实的乳腺肿块患者进行高频彩超检查,并分析对比良、恶性肿块的二维超声特点及彩色多普勒血流特征。结果:236例乳腺肿块中,良性肿块173例,恶性肿块63例,良性肿块超声诊断符合率为95.4%(165/173),恶性肿块超声诊断符合率为92.1%(58/63)。结论:以高频二维超声检查为基础,结合彩色多普勒的血流特征,对诊断乳腺肿块的良恶性具有重要意义。

    [关键词] 乳腺肿块;高频彩超;鉴别诊断

    [中图分类号] R445.1[文献标识码] B [文章编号]1673-7210(2010)06(a)-101-02

    Diagnostic value of high frequency color Doppler flow imaging for differentiating benign and m alignant breast tumors

    YE Changkong

    (Department of Function Branch B Ultra Room, Beihai People's Hospital of Guangxi Zhuang Autonomous Region, Beihai 536000, China)

    [Abstract] Objective: To evaluate the diagnostic value of high frequency color Doppler flow imaging for differentiating benign and m alignant breast tumors. Methods: The 236 cases of mammary gland tumor patients confirmed after the surgery pathology carried on the high frequency color Doppler inspection, and analyzed and contrasted the two-dimensional ultrasound features and the color Doppler flow features between the benign breast tumors and the m alignant breast tumors. Results: There were 173 benign breast tumors, 63 m alignant breast tumors. Benign tumor ultrasound diagnosis coincidence rate was 95.4% (165/173), m alignant tumor ultrasound diagnosis coincidence rate was 92.1% (58/63). Conclusion: Base on the high frequency two-dimensional supersonic inspection, and unite the color Doppler's blood stream feature, that has an important significance for the benign and m alignant mammary gland tumor diagnosed.

    [Key words] Mammary gland tumor; High frequency color Doppler; Differentiating diagnosis

    乳腺肿块是女性常见病,乳腺癌是我国妇女最常见的恶性肿块。据我国统计,乳腺癌占妇女恶性肿瘤的第二位[1]。近年来乳腺癌的发病率呈逐年上升的趋势,因此,乳腺肿块良恶性的鉴别是影像学研究的重点。本文对236例乳腺肿块患者的超声检查与病理结果进行对比分析,以探讨高频彩超对乳腺良恶性肿块的鉴别诊断价值。

    1 资料与方法

    1.1 一般资料

    本组236例乳腺肿块患者为我院2007年1月～2009年12月门诊及住院女性患者,年龄19～67岁,平均48岁,均经超声检查和手术病理证实。肿块最大6.8 cm×5.0 cm×4.6 cm,最小0.9 cm×0.7 cm×0.6 cm。

    1.2 方法

    使用菲利普HD-11和迈瑞DC-6彩色超声仪,探头频率7.5~10.0 MHz,患者取仰卧位或左右侧卧位,双手上举,充分显示双侧乳腺及腋窝,将探头直接置于乳腺皮肤表面,首先用二维超声仔细观察乳房各个象限,发现肿块后,仔细观察并记录肿块的大小、形态、方位、边界、内部回声(有无衰减及钙化灶)、有无包膜以及与周围组织的关系,然后采用彩色多普勒血流显像观察肿块的内部及周边血流分布情况,采用Alder半定量血流分析法对肿块内部血流进行分级:0级病灶内无血流;Ⅰ级少量血流信号,肿块内见1~2条点状或细棒状血流信号;Ⅱ级中量血流信号,可见3~4条点状血流或1条主要血管,长度大于肿块1/2;Ⅲ级血流丰富,可见4条以上血管。

    2 结果

    2.1 病理诊断结果

    本组236例肿块患者,手术病理证实恶性肿块63例,占26 ......

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