不同病理学类型乳腺黏液腺癌的声像特征对比研究  

Comparative study on ultrasonographic characteristics of different types of mucinous breast carcinoma

作　　者：李云华 贾超 李刚 史秋生[1] 杜联芳[1] 王晶[2] LI Yunhua;JIA Chao;LI Gang;SHI Qiusheng;DU Lianfang;WANG Jing(Department of Ultrasound,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai 201620,China;Department of Pathology,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai 201620,China)

机构地区：[1]上海交通大学附属第一人民医院超声科,上海201620 [2]上海交通大学附属第一人民医院病理科,上海201620

出　　处：《肿瘤影像学》2020年第5期429-435,共7页Oncoradiology

基　　金：国家自然科学基金(81771838)。

摘　　要：目的:探讨不同病理学类型乳腺黏液腺癌(mucinous breast carcinoma,MBC)的常规超声、超声弹性及超声造影声像特征。方法:回顾并分析41例MBC患者共41个病灶(单纯型组20例,混合型组21例)的超声声像特征,比较不同病理学类型MBC的声像差异。结果:单纯型与混合型MBC在肿瘤形态、边缘、血流信号及弹性评分的差异有统计学意义(P<0.05),而在肿瘤大小、内部及后方回声等常规声像,淋巴结转移率及误诊率,超声造影表现及免疫组织化学结果等方面差异均无统计学意义(P>0.05)。结论:MBC具有一定的超声影像学特征,尤其是单纯型,多数肿瘤表现为边界清晰、形态规则及后方回声增强等类似良性声像特征,容易误诊或漏诊,需引起超声科医师充分重视。联合超声造影及超声弹性技术有利于提高MBC的诊断准确率。Objective:To investigate ultrasonographic features of different pathological types of mucinous breast carcinoma(MBC).Methods:We retrospectively reviewed the ultrasonographic findings of 41(41 lesions,20 pure type and 21 mixed type)pathologically-confirmed cases of MBC,including images in B-mode ultrasound,ultrasonographic elastography(UE)and contrast-enhanced ultrasound(CEUS).Results:The pure group had significantly higher rates in regular shape,smooth margin,non-vascularity,lower elastographic score(ES)than the mixed group(P<0.05).No significant differences were observed between the two groups in the size,internal echogenicity,intratumoral calcification,posterior acoustic enhancement and the other B-mode characteristics,CEUS imaging,immunohistochemistry results,the rate of misdiagnosis and axillary lymph node metastasis also showed no significant difference between two groups(P>0.05).Conclusions:Well circumscribed,regular shape and posterior acoustic enhancement are more commonly found in the B-mode images of MBC(especially the pure type)as benign tumors,so there are many misdiagnosis or missed diagnosis in clinical practice,which should be taken seriously by ultrasound doctors.Combination of CEUS and UE images is useful to improve the diagnostic accuracy.

关 键 词：常规超声 超声造影 超声弹性 黏液腺癌 病理诊断 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]