乳腺良恶性病变的超声综合指标诊断与病理对照分析

目的分析乳腺肿瘤的高频二维超声及彩色多普勒血流显像（CDFI）、超声弹性成像的特点，评价其对乳腺癌的诊断价值。方法经术后病理证实的乳腺肿瘤患者113例，对其临床资料进行州顾性分析，将二维超声声像图特征、CDFI、弹性成像等多项指标进行比较。结果高频二维超声对乳腺肿瘤的形态、边界、包膜、有无微小钙化、腋窝淋巴结探及等方面，良、恶性肿瘤之间差异有显著性，腋窝转移性淋巴结是恶性肿瘤的特点。乳腺良性肿瘤CDFI表现为血流丰富的占70．1％，多为0～I级，而乳腺癌CDFI表现以II～III级多见，占82．6％。超声弹性成像5分法评价乳腺肿瘤，4分以上诊断为恶性，3分以下诊断为良性，其敏感性、特异性和准确性分别为84．8％、92．5％和89．4％。结论将乳腺肿瘤的高频二维超声、CDFI特点及弹性成像评价超声综合指标结合起来分析，可显著提高乳腺癌诊断率。

Comparison of ultrasonic diagnosis with pathological examination for benign and malignant breast lesions

Objective To analyze the features of breast neoplasms on two- dimensional highfrequency ultrasound, color Doppler flow imaging (CDFI), and ultrasonic elastography (UE) and to assess the values of these ultrasonic diagnosis. Methods The data on 113 patients with pathologically confirmed breast tumors were retrospectively analyzed. Features of benign and malignant lesions on two-dimensional ultrasound CDFI and UE were compared. Results There were significant differences between benign and malignant breast regarding appearance of the lesions including shape, edge, capsule,and existence of calcification. Metastasis to axillary lymph nodes was the sign of breast cancers. On CDFI,the detection rate of blood flow in small benign masses was 70.1%, mostly with a grade of 0 - I, while that in breast cancers was 82.6%, with a grade of Ⅱ - Ⅲ. 5-scoring systme was used for evaluation (score 4 or above for malignancy and score 3 or below for benign lesions)and the sensitivity, specificity and accuracy of UE was 84.8%, 92.5%, and 89.4%. Conclusions Comprehensive analysis of the features of breast tumors on two-dimensional ultrasound, color Doppler flow imaging , and ultrasonic elastography can markedly increase the diagnostic rate of breast cancer.