82例恶性乳腺肿块二维及彩色多普勒诊断价值的分析  

Diagnosis Value of Malignant Breast Masses in 82 Cases with B mode and Color Doppler ultrasonography

作　　者：陈曼[1] 龚新环[1] 王枫钊[1] 

机构地区：[1]上海第二医科大学附属瑞金医院超声诊断科

出　　处：《中国超声医学杂志》1998年第12期59-61,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的：重点分析恶性乳腺肿块的二维声像图表现及彩色多普勒血流状况，旨在探讨恶性乳腺肿块的超声特点。方法：８２例恶性乳腺肿块经二维超声了解其形态、边界、边缘、纵横比、内部回声、有无后方衰减及侧方声影等，然后用彩色多普勒检查，观察肿块内部及周边有无血流、并根据其丰富程度分成四个等级：０、Ⅰ、Ⅱ、Ⅲ级。结果：本组绝大多数恶性乳腺肿块形态不规则（８０／８２，占９７．６％）、边界不清（７２／８２，占８７．８％）、内部回声不均匀（７４／８２，占９０．２％）、纵横比＞１（８１／８２，占９８．８％）、边缘不规则（４１／８２，占５０％）。肿块血流显示率９１．４％（７５／８２），丰富程度以Ⅱ级和Ⅲ级为主，其中Ⅱ＋Ⅲ级为８４．４％。根据以上结果，作者提出只要肿块具备①形态不规则；②边界不清；③边缘不规则；④内部回声不均匀；⑤后方衰减，以上五项中的三项或包括第③项在内的两项者，同时彩色多普勒检出Ⅱ、Ⅲ级的血流信号，即可诊断为恶性乳腺肿块，其准确性达９２．７％（７６／８２）。结论：恶性乳腺肿块的超声诊断应以二维声像图为基础。objectives:To analyse the sonographic morphology characteristics and blood flow on color Doppler sonogram of the malignant breast masses.Methods:Eighty two biopsy proven malignant breast masses were evaluated with B mode sonogram to find out the sonographic morphology characteristics(morphology boundary,margin,longitudinal transverse ratio(L/T),distal acoustic shadow,lateral shadow),and with color Doppler sonogram to observe if there had blood flow in and around the masses.The density of the singals was graded into four grades as 0,Ⅰ,Ⅱ,Ⅲ.Results:The morphology characteristics of the malingnant breast masses were irregular(80/82,97 6%),indistinctly defined border(72/82,87 8%),inhomogenous echogenecity(74/82,90 2%),L/T>1(80/82,98 8%),irregular margin(41/82,50%)and distal acoustic shadow(14/82,17 1%).The detection rate of flow singals was 91 4%(75/82),84 4% of the malingant breast masses belonged to Ⅱ and Ⅲ.As a result,if there were any three points of these above sonographic mophology characteristics mentioned or the third point plus any other one,combined with the density of the flow singals belonged to Ⅱ or Ⅲ,it could be diagnosised as malignant.Its accuracy rate was 92 7%(76/82).Conclusions:The diagnosis standard of the malignant breast masses must depend on the morphology characteristics and closely combined with the density of the flow singals on color Doppler sonogram.

关 键 词：二维超声波 彩超 乳腺肿瘤 诊断 

分 类 号：R737.904[医药卫生—肿瘤]