术前超声在诊断和定位切除乳腺触诊阴性肿块的应用  

Application of preoperative ultrasonography to diagnose and localize negative palpation of breast lesions in surgical excision

作　　者：赵勇[1] 贾淑文[2] 

机构地区：[1]四平市妇婴医院乳腺外科,吉林四平136000 [2]四平市妇婴医院电诊科,吉林四平136000

出　　处：《中国实验诊断学》2011年第2期290-292,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨术前超声在诊断和定位切除乳腺触诊阴性肿块的应用价值。方法自2007年1月至2009年1月,对我院83例95个临床触诊阴性乳腺肿块在术前行高频二维及彩色多普勒超声检查,获取超声直接和间接征象图特征,并在皮肤上行十字交叉定位,然后手术切除乳腺肿块并作病理检查。计算术前超声定位在切除乳腺触诊阴性肿块准确性及超声诊断恶性乳腺触诊阴性肿块灵敏性、特异性、阳性预测值、阴性预测值和符合率。结果 83例的95个临床触诊阴性乳腺肿块中92个在术前超声定位下被手术切除,准确性为96.8%。术后病理结果为良性80个,恶性15个。超声诊断恶性乳腺触诊阴性肿块灵敏性66.67%、特异性84.05%、阳性预测值80.91%、阴性预测值84.05%、符合率93.68%。直接征象中肿瘤纵横比≥1、内部回声不均匀、微钙化、Ⅱ~Ⅲ级血流、穿支血管、阻力指数≥0.7对早期诊断临床触诊阴性乳腺癌具有重要意义。结论术前超声对乳腺触诊阴性肿物性质判断和指导准确手术切除具有重要价值。Objective To study the value of preoperative ultrasound to diagnose and localize negative palpation of breast lesions in surgical excision.Methods From January 2007 to January 2009,preoperative ultrasonography to diagnose and localize negative palpation of breast lesions of 95 negative palpation of breast lesions in the 83 cases.The results of ultrasonography were compared with pathology.Sensitivity,specifity,positive predictive rate,negative predictive rate and accurate rate of ultrasonography were measured.Results In the 83 cases（95 lesions）,Wide local excisions were performed in 92 lesions（96.8%） with localization of Preoperative ultrasonography.Compared with negative palpation of breast lesions（80 benign,15malignant）,there were statistical significance of the direact signs of length/width≥1,uneven internal echo,micro calcifications,Grade Ⅱ-Ⅲ flow,afferent artery and resistance index（RI）≥0.7（P0.01）.Sensitivity,specifity,positive predictive rate,negative predictive rate and accurate rate of ultrasonography were66.67%,84.05%,80.91%,84.05%,93.68%.Conclusion Preoperative ultrasonography was significant to diagnose and localize negative palpation of breast lesions in surgical excision.

关 键 词：乳腺肿瘤 触诊 超声检查 诊断 手术 

分 类 号：R737.9[医药卫生—肿瘤]