乳腺微浸润癌与导管原位癌及浸润性导管癌声像图特征对比研究  

Comparative study of ultrasound characteristics on microinvasive breast carcinoma, ductal carcinoma in situ and invasive ductal carcinoma

作　　者：陈小霜[1] 魏巍丽[1] 陈志奎[1] 林礼务[1] 薛恩生[1] 俞丽云[1] 何以敉[1] 

机构地区：[1]福建医科大学协和临床医学院福建医科大学附属协和医院超声科,福州350001

出　　处：《中华超声影像学杂志》2015年第8期688-691,共4页Chinese Journal of Ultrasonography

基　　金：福建医科大学教授基金（JS09013）

摘　　要：目的探讨乳腺微浸润癌（microinvasive breast carcinoma，MBC）的声像图特征，提高其超声检出率。方法根据超声表现将经病理证实的65例MBC、85例乳腺导管原位癌（ductal carcinoma in situ，DCIS）、99例乳腺浸润性导管癌（invasive ductal carcinoma，IDC）病灶分为肿块型与导管型两型，并回顾性对比分析其声像图特征。结果MBC组肿块型占89．23％（58／65），共64个病灶，导管型占10．77％（7／65）；DCIS组肿块型占88．24％（75／85），共78个病灶，导管型占11．76％（10／85）；IDC组均为肿块型，共1（12个病灶。肿块型MBC声像图表现多数呈实质性低回声灶，病灶最大径平均值大于DCIS，与IDc相近（P〉0．05）；形态不规则及钙化灶较DCIS多见（P〈0．05），与IDC差异无统计学意义（P〉0．05）；边缘毛刺、蟹足征的检出率高于DCIS（P〈0．05），低于IDC（P〈0．05）；病灶边界不清、纵横比≥0．7、周边高回声晕的检出率低于IDC（P〈0．05），与DCIS相近（P〉0．05）。导管型MBC管壁模糊者较DCIS多见（P〈0．05）。MBC两型病灶的2～3级血流信号检出率均高于DCIS。结论MBC声像图在病灶增大、形态不规则、边缘短小毛刺及微钙化灶等表现上较DCIS更加显著，但与IDC比较，其边缘毛刺征缺乏典型性，周边蟹足样改变、周围高回声晕及纵横比增大较少见。充分认识MBC的声像特点，对提高其超声检出率具有重要的临床意义。Objective To investigate the ultrasound characteristics of microinvasive breast carcinoma （MBC）, and to improve its detection rate. Methods Sixty-five MBC, 85 breast ductal carcinoma in situ （DCIS） and 99 breast invasive ductal carcinoma（IDC） confirmed by pathology were divided into mass type and ductal type according to ultrasonic manifestaions,and the ultrasound characteristics were retrospectively analyzed. Results MBC showed 89.23%（58/65） mass type with 64 lesions and 10.77%（7/65） ductal type. DCIS showed 88.24% （75/85） mass type with 78 lesions and 11.76% （10/85） duetal type. IDC group showed all mass type with 102 lesions. In MBC, most mass type lesions were solid and hypoechoic with a mean maximum diameter,which was larger than DCIS, but similar with IDC（ P〈0.05）. More mass type lesions with irregular shape and calcification were found in MBC than in DCIS（ P〈0.05）, while similar with IDC（ P〈0.05）. The detection rate of spiculate margin in mass type lesions of MBC was higher than DCIS（ P〈0.05） ,but lower than IDC（ P〈0.05）. Less mass type lesions showed unclear border,high A/T ratio and hyperechoic halos in MBC than in IDC（ P〈0.05）, but similar with DCIS（ P 〉0.05）. More ductal type lesions displayed indistinct duct wall in MBC than DCIS（ P〈0.05）. Meanwhile, MBC had a higher detection rate of internal blood flow（grade 2 - 3） than DCIS. Conclusions There are more lesions with large diameter,irregular shape,short spiculate margin and calcification in MBC than DCIS. Compared with IDC, MBC lesions are atypical in spiculate margin, and less lesions show hyperechoic halos and high A/T ratio. To be familiar with ultrasound characteristics of MBC is significant for improving its ultrasound detection rate.

关 键 词：超声检查 乳腺肿瘤 乳腺微浸润癌 

分 类 号：R737.9[医药卫生—肿瘤]