乳腺叶状肿瘤超声表现与病理相关性研究  

Correlation between ultrasonic appearance and pathology of phyllodes tumors of the breast

作　　者：霍兰茹[1,2] 刘佩芳[1] 徐熠琳[1] 李小康[1] 邵真真[1] 朱鹰[1] 

机构地区：[1]天津医科大学肿瘤医院乳腺影像诊断科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,乳腺癌防治教育部重点实验室,天津市300060 [2]天津市西青医院超声诊断科

出　　处：《中国肿瘤临床》2014年第9期571-575,共5页Chinese Journal of Clinical Oncology

基　　金：天津市科技计划中国乳腺癌预防模式与诊断技术研究项目(编号:12ZCDZSY16000)资助 ~~

摘　　要：目的：分析乳腺叶状肿瘤的超声特点，以提高对该病的认识。方法：按照美国放射学院（American College of Radiolo-gy，ACR）乳腺超声BI-RADS诊断标准，回顾性分析天津医科大学肿瘤医院85个乳腺叶状肿瘤的超声图像及病理资料。结果：85个叶状肿瘤中良性33个、交界性28个和恶性24个。肿物形态多呈分叶状、边界清晰、边缘光滑、内部回声不均匀。其中良性叶状肿瘤边界清晰更为常见（χ2=12.721，P=0.002）；恶性叶状肿瘤内部多可见囊性无回声区（χ2=9.677，P=0.046）。彩色血流成像显示：75.3%（64/85）的肿物内部探及Ⅱ～Ⅲ级血流信号。26个病变进行了弹性成像，88.5%（23/26）的肿块弹性成像评分为2～3分。结论：乳腺叶状肿瘤的超声表现具有一定特征，肿块边界是否清晰和肿块内部是否存在小囊性无回声区是鉴别良恶性叶状肿瘤的重要依据。Objective：This study aims to evaluate the sonographic features of phyllodes tumors of the breast （PTBs） and the cor-relation between sonographic and pathologic findings to improve the understanding of the disease. Methods：Sonographic findings of 85 PTBs from 83 patients were reviewed. The sonographic findings included the results of two-dimensional ultrasound and color Dop-pler flow imaging, elastographic features, and pathologic data. Results：Of the 85 lesions, 33 were the benign tumors, 28 were border-line, and 24 were malignant according to the pathologic diagnosis. Tumor morphology revealed that most masses were lobulated, with a clear-cut boundary, smooth verge, and inhomogeneous internal echo. Clear boundary was more common in the benign phyllodes tumors （χ2=12.721, P=0.002）, and a cystic echo-free area was more commonly observed in these malignant tumors （χ2=9.677, P=0.046）. LevelⅡandⅢsignals of the blood flow were observed in 75.3%of PTB cases. Of all lesions, only 26 were subjected to elasticity imaging, and the elastographic scores ranged from 2 to 3 in 88.5%of the cases （23/26）. Conclusion：Conventional ultrasound and elastographic findings on PTBs exhibited definite characteristics. The border and cystic areas in the tumors can be used to differentiate between be-nign and malignant PTBs.

关 键 词：乳腺 叶状肿瘤 超声检查 病理 弹性成像 

分 类 号：R737.9[医药卫生—肿瘤]