彩色多普勒超声鉴别诊断良恶性乳腺肿块  

Color Dopplor ultrasound in differential diagnosis of benign and malignant breast masses

作　　者：张晓晓[1] 詹维伟[1] 贾懿[1] 朱樱[1] 姚洁洁[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院超声诊断科,上海200025

出　　处：《中国医学影像技术》2014年第12期1844-1847,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨彩色多普勒超声鉴别良恶性乳腺肿块的价值。方法回顾性分析经手术病理确诊的589例患者（631个乳腺肿块）的超声资料。分析肿块血管模式、血供程度、有无穿支血管、血管走行是否规则及肿块周围血供有无弥漫性增加,比较良恶性肿瘤间上述指标差异;根据肿块最大径将肿块分为≤10mm、11～20mm、21～50mm和〉50mm组,比较不同大小肿块组间、组内良恶性肿块血供程度差异。结果良恶性肿块血管供血模式、血供程度、血管走行、穿支血管、周围血供差异均有统计学意义（P均〈0.05）。随着肿块增大,良恶性肿块血供程度均增加（P均〈0.05）;最大径≤50mm肿块中,良恶性肿块血供程度差异有统计学意义（P均〈0.05）,最大径〉50mm肿块中,良恶性肿块血供程度差异无统计学意义（P均〉0.05）。以Adler分级≥Ⅱ级作为诊断恶性肿瘤指标,诊断敏感度为64.82%（164/253）、特异度为71.43%（270/378）、准确率为68.78%（434/631）。结论良恶性乳腺肿块彩色多普勒超声参数存在一定差异,血供程度对于鉴别最大径≤50mm乳腺肿块良恶性有一定提示作用。Objective To explore the value of color Doppler ultrasound in differential diagnosis of benign and malignant breast masses.Methods Ultrasound data of 589 patients with 631 breast masses confirmed by postoperative pathology were retrospectively analyzed.The flow pattern,blood supply,penetrating vessels and diffusely increased vascularity in surrounding tissue were assessed and compared between benign and malignant masses.According to the maximum diameter the masses were divided into ≤10mm,11～20mm,21～50mm and 〉50mm groups,the blood supply among different maximum diameter group and between benign and malignant masses of the same maximum diameter group were compared.Results The flow pattern,blood supply,penetrating vessels and diffusely increased vascularity in surrounding tissue were all different between benign and malignant breast masses（all P〈0.05）.The blood supply increased with the enlargement of the mass（all P〈0.05）.The blood supply was richer in malignant tumor compared with benign lesion in masses with maximum diameter ≤50 mm,but was no significantly different with benigh lesion in masses with maximum diameter〉50mm（P〉0.05）.Taken Adler grade≥Ⅱas indicators for diagnosis of malignant breast tumor,the sensitivity,specificity and accuracy rate was 64.82%（164/253）,71.43%（270/378）and 68.78%（434/631）.Conclusion There were differences of color Doppler ultrasound parameters between benign and malignant masses and the blood supply can be useful for identification of benign and malignant breast masses with maximum diameter≤50mm.

关 键 词：超声检查 多普勒 彩色 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] R737.9[医药卫生—诊断学]