超声在乳管内乳头状病变诊断中的价值  

Diagnostic value of ultrasonography evaluation in patients with intraductal papillary lesions of breast

作　　者：李征毅[1] 张家庭[1] 李泉水[1] 冯健[1] 张婵[1] 刘跃华[2] 

机构地区：[1]广东省深圳市第二人民医院(南方医科大学附属深圳医院)超声科,广东深圳518035 [2]广东省深圳市第二人民医院(南方医科大学附属深圳医院)乳腺外科,广东深圳518035

出　　处：《中国现代医学杂志》2009年第13期1998-2000,2004,共4页China Journal of Modern Medicine

摘　　要：目的评价超声显像对乳管内乳头状病变的诊断价值。方法分析53例导管内占位病变的超声表现,8例患者辅以乳腺导管注液再次超声检查,并与病理检查结果相对照。结果53例乳管扩张的患者中超声可显示肿块48例(平均测量值为7mm),5例未能清楚显示局部肿块。超声主要表现为:实质性回声伴或不伴导管扩张,囊性回声内壁立结节或以实质性回声为主的囊实混合病灶,囊壁或实质内可见钙化15例,部分实质回声内可见血流信号(26例)。声像图分3型:导管内肿块伴或不伴导管扩张(16例);囊实混合性回声病变(23例);实质性回声肿块,部分可见导管样铸形(9例)。病理结果显示导管内乳头状瘤24例,多发性乳头瘤病7例,导管上皮增生9例,乳头状瘤合并导管内原位癌2例,导管内乳头状癌11例。结论高频彩超在发现和诊断乳管内乳头状病变方面价值较高,是诊断该种疾病的一种有效方法。[Objective] The purpose of this study was to evaluate the diagnostic value of breast ultrasonography （US） in the ductal breast disease. [Methods] Sonographic findings of intraductal lesions in 53 cases （8 of 53 cases which presence mammary-duct ectasia or normal in the routine US were underwent US examinations again after breast ductal lavage） were retrospectively analysed and correlated with clinical and pathological features. [Results] In 48/53 cases, US revealed neoplasms of breast （mean size 7 mm）, the others were failed to visualized. Ultrasound features of intraductal papillary neoplasms （IPN）： solid mass with or without ductal dilatation, intracystic mass and a predominantly solid pattern with the intraductal mass, calcification exhibit in peripheral or central of the lesions in 15/43 case, color flow within masses were found in 26 cases. Ultrasound features of the masses were classified into three categories： type I - intraluminal mass with or without ductal ectasia （16/48）; type II -mixed variety （23/48）; type III- purely solid mass （9/48）. Histopathological evaluation： twenty-four solitary papillomas, seven multiple papillomas, two solitary papillomas with a focal area of ductal carcinoma in situ （DCIS）, and eleven intraductal carci- nomas. [Conclusion] High-frequency US plays an important role in the detection of ductal disease. It is effective for diagnosing focal masses and mammary-duct.

关 键 词：乳腺 超声显像 乳头状瘤 乳管病变 

分 类 号：R737.9[医药卫生—肿瘤]