乳腺叶状肿瘤的二维、彩色及弹性超声表现

目的:探讨乳腺叶状肿瘤的二维、彩色及弹性超声图像特点。方法:回顾分析16例经病理证实的乳腺叶状肿瘤的超声图像资料。结果:16例乳腺叶状肿瘤均为单发,术后病理诊断为良性8例,交界性4例,恶性4例;良性、交界性、恶性肿瘤的平均直径为30、41、38 mm;16个肿块中,12个呈分叶状,4个呈卵圆形;16个肿块均边界清晰,2个恶性叶状肿瘤局部包膜不完整;12个肿块内见裂隙状无回声区和高回声分隔,肿块后方回声均增强。良性、交界性及恶性肿瘤中分别有7、3、4例的血流呈II~III级。弹性超声图像显示,15个肿块內见横向分布的红黄色条纹;8个肿块内红黄色条纹大于10条;2个交界性肿瘤及2个恶性中央见红绿相间,周围为蓝色,呈"戒指征"。良性、交界性、恶性叶状肿瘤中分别有7、3、2例弹性评分为1分,分别有1、1、2例弹性评分为3分。结论:乳腺叶状肿瘤多为分叶状,边界清晰,内见裂隙状无回声及高回声分隔,后方回声增强,血流丰富;典型弹性超声图像可见大量横向红黄色条纹。如乳腺叶状肿瘤包膜不完整、弹性评分3分或见蓝色"戒指征",应考虑交界性或恶性的可能。

Two-Dimensional Ultrasound,Color Doppler Ultrasound and Ultrasonic Elastography Features of Breast Phylloides Tumors

Objective：To investigate the two-dimensional ultrasound ,color Doppler ultrasound and ultrasonic elastography fea-tures of breast phylloides tumors .Methods ：Sixteen cases of breast phylloides tumors proved by pathology were retrospectively analyzed .Results：In all cases ,there was a single tumor .Postoperative pathological results proved benign ,borderline and ma-lignant breast phylloides tumor in 8 ,4 and 4 cases ,respectively ;and the mean diameters of them were 30 mm ,41 mm and 38 mm ,respectively .Twelve lesions were lobulated and 4 oval in 16 tumers .The tumor margins were circumscribed in all cases , and 2 malignant lesions had incomplete capsules .Intramural clefts and high echo separations were found in 12 lesions .All le-sions had posterior enhancement .Grade II-III blood flow were seen in 7 benign lesions ,3 borderline lesions and 4 malignant le-sions .In ultrasontic elastography fifteen lesions had horizontal red/yellow stripes ,8 lesions had more than ten red/yellow stripes ,2 borderline lesions and 2 malignant lesions had a mosaic pattern of red and green in the centre and blue “ring sign”in the periphery .There were 7 ,3 ,2 lesions scored as 1 ,and 1 ,1 ,2 lesions scored as 3 on ultrasonic elastography for benign , borderline and malignant phylloides tumors ,respectively .Conclusions：The breast phylloides tumors mostly present as lobulated , well circumscribed ,intramural cleft ,high echo separations ,posterior enhancement and abundant blood flow on ultrasound . Many horizontal red/yellow stripes are typical appearance of breast phylloides tumors on elastography .Incomplete capsule , scored as 3 on elastography or blue“ring sign” in the periphery suggest borderline and malignancy phylloides tumors .