不同分型乳腺错构瘤的临床特征和超声表现分析  

Clinical characteristics and ultrasound manifestations of different subtypes of breast hamartoma

作　　者：陈露 郑霞 倪平娟[1] 庞坤坤 刘真 张飞雪[1] CHEN Lu;ZHENG Xia;NI Pingjuan;PANG Kunkun;LIU Zhen;ZHANG Feixue(Department of Ultrasonograph,The Second Hospital of Shandong University,Jinan 250033,China;不详)

机构地区：[1]山东大学第二医院超声科,山东济南250033 [2]齐河县人民医院急诊科,山东德州251199

出　　处：《山东医药》2025年第2期95-100,共6页Shandong Medical Journal

摘　　要：目的分析不同分型乳腺错构瘤的临床特征和超声表现。方法选择乳腺错构瘤患者53例,根据瘤体内部成分含量不同,分为混合型、脂肪型、致密型三种类型。回顾性分析不同分型乳腺错构瘤的临床资料、超声表现及其误诊情况。结果53例乳腺错构瘤患者中,混合型34例、脂肪型14例、致密型5例,均为单侧乳房发病。不同分型乳腺错构瘤患者年龄、病程分布以及月经状态、疾病症状、疾病发现方式比较差异均无统计学意义(P均>0.05)。混合型乳腺错构瘤超声表现为混合回声,在低回声团块内可见边缘模糊的稍高回声团块,呈“浮岛”征;脂肪型乳腺错构瘤超声表现为高回声,有时可表现为稍低回声,伴条索状或小片状高回声;致密型乳腺错构瘤超声表现为均匀低回声,少部分边缘见稍高回声。不同分型乳腺错构瘤瘤体形态多规则,呈椭圆形,包膜多比较完整,边界清晰,无钙化,后方回声无明显变化;肿块内血流信号均不丰富;双侧腋窝无肿大淋巴结。不同分型乳腺错构瘤在最长径线、病变与腺体位置关系、内部回声方面比较差异均有统计学意义(P均<0.05),而在病变位置、象限分区、形态、包膜、“导管样”结构及CDFI等方面比较差异均无统计学意义(P均>0.05)。53例乳腺错构瘤超声误诊20例,误诊为脂肪瘤14例、增生结节4例、纤维腺瘤2例。混合型乳腺错构瘤误诊4例,误诊为脂肪瘤3例、增生结节1例;脂肪型乳腺错构瘤误诊11例,均误诊为脂肪瘤;致密型乳腺错构瘤误诊5例,误诊为纤维腺瘤2例、增生结节3例。不同分型乳腺错构瘤误诊比较差异有统计学意义(P<0.05)。结论不同分型乳腺错构瘤多单侧乳房发病,临床特征差别不大,但超声表现有所不同。乳腺错构瘤易误诊,混合型乳腺错构瘤因超声表现典型误诊最少,而致密型乳腺错构瘤超声表现多为低回声,较少见,最易误诊。Objective To analyze the clinical characteristics and ultrasonic manifestations of different subtypes of breast hamartoma.Methods Fifty-three patients with breast hamartoma were selected and classified into three types based on the content of internal components:mixed type,fat type,and dense type.We retrospectively analyzed the clinical and pathological data,ultrasound findings,and misdiagnosis of three subtypes of breast hamartoma.Results Among the 53 patients with breast hamartoma,there were 34 cases of mixed type,14 cases of fat type,and 5 cases of dense type,all of which were unilateral breast lesions.There were no statistically significant differences in age,disease course distribution,menstrual status,disease symptoms,or disease detection methods among patients with different subtypes of breast hamarto ma(all P>0.05).Mixed type ultrasound showed mixed echoes,with slightly higher echo masses with blurred edges visible within the low echo masses,presenting a"floating island"sign;fat type ultrasound showed high echogenicity,sometimes slightly low echogenicity,accompanied by linear or small patchy high echogenicity;dense type ultrasound showed uniform low echo with slightly high echo at the edges.The shapes of different subtypes of tumors were mostly regular,presenting as elliptical,with mostly intact capsules,clear boundaries,no calcification,and no significant changes in posterior echoes.The blood flow signals within the masses were not abundant.There were no enlarged lymph nodes in the bilateral axillae.There were statistically significant differences in the longest diameter,relationship between lesion and glandular location,and internal echo among different subtypes of breast hamartoma(all P<0.05),while there were no statistically significant dif ferences in lesion location,quadrant zoning,morphology,capsule,"ductal"structure,or CDFI(all P>0.05).Among 53 cases of breast hamartoma,20 were misdiagnosed by ultrasound,including 14 cases of lipoma,4 cases of hyperplastic nod ules,and 2 cases of fibroadenoma;four

关 键 词：乳腺错构瘤 超声表现 误诊 

分 类 号：R737.9[医药卫生—肿瘤]