乳腺癌患者保乳术后局部异常声像的超声鉴别诊断  

Ultrasound Differential Diagnosis of Circumscribed Unclear Lesions after Breast-Conserving Surgery

作　　者：范海波[1,2] 宋红[1,2] 甘晗靖[1,2] 林琪[1,2] 焦阳[1,2] 

机构地区：[1]深圳市人民医院 [2]暨南大学第二临床学院超声科,广东省深圳市518000

出　　处：《中国全科医学》2012年第24期2738-2741,共4页Chinese General Practice

基　　金：深圳市科技计划项目--乳腺肿块切除术后手术野异常声像的超声诊断研究(200903020)

摘　　要：目的分析乳腺癌患者保乳术后各种局部异常声像的特征并进行鉴别诊断。方法超声随访50例乳腺癌行保乳术患者不同时期各种局部异常声像图,并与钼靶、细针穿刺或手术病理相比较。结果病理检查提示:单纯瘢痕32例(64%);良性病变16例(32%),包括7例水肿及血肿,4例脂肪坏死,2例肉芽肿,4例淋巴囊肿(其中1例并发水肿);恶性病变(肿瘤残留)2例(4%)。超声检查提示:恶性病变4例,其中肿瘤残留2例,误诊2例(1例为脂肪坏死,1例为肉芽肿);单纯瘢痕32例(64%);良性病变14例(28%)。与病理诊断结果比较,超声诊断良恶性病变的符合率为96%,误诊率为4%。结论超声可作为乳腺癌患者保乳术后随访的重要检查手段之一,能有效鉴别各种局部异常声像。Objective To assess the characteristics of circumscribed unclear lesions after breast - conserving surgery and to make differential diagnosis. Methods Circumscribed unclear lesions of different periods in 50 breast - cancer patients after breast - conserving surgery were followed up by ultrasound. The ultrasonography performance was analyzed and compared with clin- ical data of mammography, fine needle biopsy and pathology. Results Pathological findings showed that 32 Cases （64%） had simple scar, 16 cases （32%） had benign lesions, including seven cases of oedema and haematoma, four cases of fat necrosis, two cases of granuloma and four cases of lymph cysts （ one case accompanied by oedema） and two cases had malignant lesions （cancer residue, 4% ） . Ultrasonography showed that four cases had malignant lesions, including two cases of cancer residue and two cases of misdiagnosis （one was fat necrosis and the other was granuloma）, 32 cases had simple scar （64%） and 14 ca- ses had benigh lesions （28%） . Compared with pathological findings, the accordance rate of ultrasanography in diagnosing be- nign and malignant lesions was 96% and the misdiagnosis rate was 4%. Conclusion Uhrasonography can effectively differentiate circumscribed unclear lesions after breast -conserving surgery and can be used as an important tool during the following up.

关 键 词：乳腺肿瘤 保乳手术 超声检查 多普勒 诊断 鉴别 

分 类 号：R737.9[医药卫生—肿瘤]