高频超声对乳腺分叶状肿瘤的诊断价值  

The Value of High Frequency Ultrasound in Diagnosis of Lobular Breast Tumors

作　　者：刘清玉 苏毅明[1] Liu Qingyu;Su Yiming(Department of Ultrasound,The First Affiliated Hospital of Xiamen University,Xiamen,Fujian 361003)

机构地区：[1]厦门大学附属第一医院超声科,福建厦门361003

出　　处：《现代医用影像学》2021年第10期1788-1792,共5页Modern Medical Imageology

摘　　要：目的:探讨高频超声对乳腺叶状肿瘤的诊断价值。方法:回顾性分析经病理证实的208例乳腺叶状肿瘤患者共233个结节的声像图表现,对良性与交界性、恶性叶状肿瘤两组间的声像图进行对比分析。结果:208例患者中,共233个结节,191个良性叶状肿瘤,31个交界性叶状肿瘤,11个为恶性叶状肿瘤。交界性、恶性叶状肿瘤的发病年龄及结节最大径均大于良性叶状肿瘤,差异有统计学意义。当结节最大径大于3.05cm,诊断交界性、恶性叶状肿瘤的ROC曲线下面积为0.723,特异性为76.4%。术前BI-RADS分类结果显示对交界性、恶性叶状肿瘤的漏诊率达77.2%。80.1%的良性叶状肿瘤的边界清晰,与交界性、恶性叶状肿瘤相比差异有统计学意义,超声对交界性、恶性叶状肿瘤内部呈囊性变的检出率大于良性叶状肿瘤,且交界性、恶性叶状肿瘤的血流信号明显多于良性叶状肿瘤,差异有统计学意义。结论:乳腺叶状肿瘤特征性超声表现为边缘呈分叶状、内部呈裂隙样改变及线状高回声,当结节较大、内部出现囊性变及血供较丰富时应高度注意交界性、恶性叶状肿瘤的可能。Objective:To investigate the diagnostic value of high frequency ultrasound in lobular breast tumors.Methods:A retrospective analysis was made of the sonographic features of 233 nodules in 208 patients with breast lobular tumors confirmed by pathology,and the ultrasonographic features of benign,borderline and malignant phyllodes tumors were compared and analyzed.Results:Of 208 patients,233 nodules,191 benign lobular tumors,31 borderline lobular tumors and 11 malignant lobular tumors were found.The incidence age and nodule diameter of borderline and malignant lobular tumors were higher than that of benign lobular tumors.When the maximum diameter of the nodule is greater than 3 cm,area under the ROC curve was 0.723 and the specificity was 76.4%in the diagnosis of borderline and malignant lobular tumors.BI-RADS preoperative classification showed 77.2%missed diagnosis of borderline and malignant lobular tumors.The boundary of 80.1%of benign lobular tumors was clear,and the difference was statistically significant compared with borderline and malignant lobular tumors.The detection rate of cystic changes in borderline and malignant lobular tumors was higher than that of benign lobular tumors,and the blood flow signal of borderline and malignant lobular tumors was significantly higher than that of benign lobular tumors.Conclusion:The characteristics ultrasonographic features of breast phyllodes tumors are lobulated margin,fissure like changes and linear hyperechogenicity.When the nodules are larger,cystic changes in the interior and abundant blood supply,we should pay more attention to the possibility of borderline and malignant lobular tumors.

关 键 词：乳腺 超声 叶状肿瘤 

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