乳腺间质内纤维结构改变对乳腺肿瘤诊断的价值  

Preliminary diagnosis value by changes of fibred structures of breast in breast tumor

作　　者：李安华[1] 韩峰[1] 熊永红[1] 陈肖选[1] 胡建明[1] 陈孝岳[1] 

机构地区：[1]中山大学附属肿瘤医院超声科,广州510060

出　　处：《中华超声影像学杂志》2005年第4期301-303,共3页Chinese Journal of Ultrasonography

摘　　要：目的探讨乳腺内纤维结构(深、浅筋膜和Cooper韧带)的改变对判断乳腺肿瘤性质的价值.方法乳腺肿瘤84例(良性31例,恶性53例),术前或活检前高频超声扫查,记录肿物周围纤维结构的声像图改变,初步判断肿物良、恶性质并按有无浸润和浸润深度分级,共两类各4级.术后将病理结果与术前的超声分级做对比分析.采用receiver operating characteristic统计法分析深、浅筋膜和Cooper韧带多变量中最有意义的参数,计算ROC曲线下面积作为精确度比较的定量指标.结果恶性肿瘤中浅、深筋膜和Cooper韧带发生改变的几率明显高于良性肿瘤,分别为64%、26%,(P<0.01).筋膜改变对判断肿物性质的准确率均高于Cooper韧带, 95%可信限范围分别为 86.3%～97.6% 和 63.9%～84.5%.诊断价值的大小依次为:浅、深筋膜受侵>Cooper韧带.结论高频超声观察乳腺内纤维结构的改变对判断肿瘤性质有重要的提示诊断价值.Objective To evaluate the diagnosis value of breast tumor by changes of fibred structures(superficial fascia, deep fascia and Cooper′s ligament) in the breast. Methods Eight four cases of breast tumors (31 benign, 53 malignancy) were involved. All the cases were scanned by high frequency ultrasound before operation or biopsy. The change of sonography of fibred structures around tumor was recorded. The kind of tumor was judged preliminarily and classified on with or without infiltration and depth of infiltration, totaling two kinds and each kind has four grades. Comparison analysis was done between the result of pathology after operation and grades of ultrasound before. Looking for the parameter of the best significance in multi variable. Results Occurrence rate of sonographic change of superficial fascia, deep fascia, and Cooper′s ligaments in malignant tumor were higher than that in benign tumor, they were 64% and 26% (P< 0.01 ). The accurate rate of judgement kind of tumor by Fascia′s change was higher than that of Cooper′s ligament, 95% confidence limit was 86.3 %- 97.6 % and 63.9 %- 84.5 %. Conclusions Observation on the changes of sonography of fibred structure within breast with high frequency ultrasound have important diagnostic value to judge the kind of breast tumors.

关 键 词：乳腺间质 纤维结构 乳腺肿瘤 高频超声 超声检查 Cooper韧带 

分 类 号：R737.9[医药卫生—肿瘤] R730.4[医药卫生—临床医学]