脂肪组织声像图改变在乳腺良恶性病变中的诊断价值  

Diagnostic value of sonographic changes of adipose tissue in benign and malignant breast lesions

作　　者：郑笑娟[1] 朱丽[1] 韩英[1] 邱林[2] 温媛媛[3] 赵臣银[4] 

机构地区：[1]温州医学院附属舟山医院超声诊断中心,浙江舟山316000 [2]温州医学院附属舟山医院信息科,浙江舟山316000 [3]温州医学院附属舟山医院病理科,浙江舟山316000 [4]温州医学院附属舟山医院肿瘤外科,浙江舟山316000

出　　处：《中华超声影像学杂志》2013年第5期429-432,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨脂肪组织声像图改变在乳腺良恶性病变中的诊断价值。方法回顾性分析92例患者共114个乳腺病灶边缘皮下脂肪组织的声像图特点，所有病灶均经手术后病理证实。以病理结果为金标准构建ROC曲线，评价皮下脂肪组织改变在乳腺良恶性病变中的诊断价值。结果61例良性病灶及53例恶性病灶的ROC曲线下面积为0．862，（P=0．000）。皮下脂肪组织声像图改变达III级及以上者提示为恶性病变，以III级为诊断乳腺恶性病变的指标，其灵敏度为73．6％，特异度为93．4％。恶性病灶的脂肪组织声像图可表现为内部纤维组织增多，脂肪回声增高，浑浊、模糊，呈“毛玻璃样”改变。脂肪改变的范围在乳腺良恶性病变中差异有统计学意义（P=0．000）。结论皮下脂肪组织声像图改变对乳腺良恶性病变的鉴别有诊断价值。Objective To investigate the diagnostic value of sonographic changes of adipose tissue in benign and malignant breast lesions. Methods The sonographic characteristics of subcutaneous adipose tissue were retrospectively analyzed in 92 patients with 114 breast lesions, all lesions were confirmed by postoperative pathology. Receive operating characteristic （ROC） curve was drew with the pathological results as standard, the diagnostic value of subcutaneous adipose tissue changes in benign and malignant breast lesions was evaluated. Results The area under the ROC curve that derived from all of the lesions （61 benign and 53 malignant） was 0. 862 （P = 0. 000）. The ultrasonographic findings which showed subcutaneous adipose tissue changes at grade III or higher suggested that the tumors were more likely malignant lesions. When adipose tissue changes at grade III was taken as the diagnostic indicator for the presence of malignant breast lesions, the diagnostic sensitivity reached 73.6% while specificity reached 93.4%. At ultrasound imaging scan, the adipose tissue in malignant lesions had the following manifestations：increased fibrosis,increased echogenicity, the sonographic images were turbidity or blurred, presence of ground-glass-like opacity. There were significant differences （ P = 0. 000） between the benign and the malignant lesions in the range of adipose tissue changes. Conclusions The ultrasonographic changes were helpful to the differential diagnosis between the benign and the malignant breast lesions.

关 键 词：超声检查 乳腺肿瘤 诊断 鉴别 

分 类 号：R445.1[医药卫生—影像医学与核医学]