乳腺黏液癌超声图像特征及误诊分析  

Ultrasonographic features and misdiagnosis analysis of mucinous carcinoma of breast

作　　者：黄润生[1] 翁立峰[1] 裴蓓[1] Huang Runsheng;Weng Lifeng;Pei Bei(Department of Ultrasound,Changzhou Second People′s Hospital,Changzhou 213003,China)

机构地区：[1]常州市第二人民医院超声科,213003

出　　处：《中华诊断学电子杂志》2018年第2期115-118,共4页Chinese Journal of Diagnostics(Electronic Edition)

摘　　要：目的探讨乳腺黏液癌的超声图像特点及超声误诊原因,以提高超声检查准确率。方法对2010年1月至2017年1月在常州第二人民医院乳腺外科经手术病理证实的58例乳腺黏液癌患者,共60个病灶(单纯型36例,共36个病灶;混合型22例,共24个病灶)的声像图做回顾性分析,超声表现包括肿块数量、大小、边界、形态、内部回声、后方回声及肿块内部是否伴微钙化灶、肿块内部血流情况及腋下淋巴结受累情况。结果 58例乳腺黏液癌患者中有44例术前超声诊断与术后病理诊断符合,超声诊断准确率为75.9%(44/58);9例单纯型乳腺黏液癌术前超声参照乳腺影像报告和数据系统(BI-RADS)分级2~3级,其中1例误诊为脂肪瘤,2例误诊为囊肿,5例误诊为纤维腺瘤或腺病,1例误诊为导管内乳头状瘤;另外5例混合型乳腺黏液癌术前超声BI-RADS分级为5级,误诊为浸润性导管癌。结论超声检查对乳腺黏液癌具有较高的诊断准确率。单纯型黏液癌具有良性乳腺肿块的一些声像图特征,应特别注意与乳腺良性肿块鉴别;混合型黏液癌具有浸润性导管癌的部分声像图特征,应特别注意鉴别。Objective To analyze the ultrasonographic features and causes of misdiagnosis of mucinous carcinoma of breast and improve the accuracy of ultrasound diagnosis.Methods The sonographic appearances and pathological features of mucinous carcinoma of breast in 58 patients(a total of 60 lesions,36 lesions of 36 cases were pure type,24 lesions of 22 cases were mixed type)diagnosed by operation and pathology were analyzed retrospectively.Ultrasonic appeareuce such as lump quantity,size,boundary,shape,internal echo,rear echo,lump internal micro calcification or not,lump internal blood stream situation and oxter lymph nodes infiltration information were analyzed.Results Among the 58 cases with mucinous carcinoma of breast,44 cases′preoperative ultrasonic diagnosis accorded with postoperative pathological diagnosis,ultrasonic diagnostic accuracy was 75.9%(44/58).Nine cases of pure type mucinous carcinoma were graded BI-RADS 2-3 by preoperative ultrasound,in which one case was misdiagnosed as lipoma,two cases were misdiagnosed as cyst,five cases were misdiagnosed as fibroadenoma or adenosis,one case was misdiagnosed as intraductal papilloma.In addition,five cases of mixed type mucinous carcinoma of breast were graded BI-RADS 5 by preoperative ultrasound and were misdiagnosed as imbibition ductal carcinoma.Conclusions Ultrasonography has higher diagnostic accuracy in mucinous carcinoma of breast.Pure type mucinous carcinoma of breast possess several characteristics of benign breast lumps,which should be distinguished from it.Mixed type mucinous carcinoma of breast has part sonographic characteristics of invasive ductal carcinoma,more attention should be paid to differentiate them.

关 键 词：乳腺肿瘤 超声检查 多普勒 误诊 

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]