乳腺叶状肿瘤的超声诊断(附33例分析)

目的探讨乳腺叶状肿瘤的声像图特点和超声诊断价值,以提高诊断水平。方法回顾分析33例经手术病理证实的乳腺叶状肿瘤患者,观察其超声的声像图表现:病变的部位、大小、形态、边界、内部回声与后方回声、有无液化和钙化,利用彩色多普勒超声观察肿块内部及周边的血流分布情况。结果 33例乳腺叶状肿瘤中,良性12例,交界性12例,恶性9例。乳腺叶状肿瘤的二维声像图表现:体积较大的分叶状肿块,边界清晰、规则,内部以实性低回声为主,回声大部分均匀,部分可见散在的无回声区,无或少有钙化,后方回声增强,所有肿块的内部和/或周边均可探及血流信号。结论超声对乳腺叶状肿瘤的定性诊断具有较高的临床应用价值。     

彩超对乳腺肿块的诊断分析

目的：回顾性分析了43倒乳腺肿块二维声像图和彩色多谱勒血流表现，探讨乳腺肿块的诊断及鉴别诊断。方法：使用Aloka5000型彩色多谱勒超声诊断仪，对43例临床拟诊乳腺肿块的患者进行检查诊断，分析其二维图象表现、血流分布信息及血流动力学改变。结果在乳腺肿块声像图诊断中，肿块后方回声及肿块边界特征是鉴别良、恶性肿块的关键。本组大多数恶性肿块后方伴有明显衰减，肿块形态不规则，边界不清内部回声低且不均匀，彩色多谱勒检出丰富血流信号。良性肿块后方无衰减。部分后方回声增强，肿块边界光整，内部回声均匀，彩色多谱勒多无明显血流信号。结论：彩超在乳腺良、恶性肿块的诊断中，具有重要的鉴别诊断价值及较大的临床应用价值。     

乳腺乳头腺瘤的超声表现

目的:探讨乳腺乳头腺瘤的高频超声图像特征.材料和方法:回顾性分析7例经术后病理证实的乳腺乳头腺瘤的超声图像资料.在灰阶声像图上观察病灶形状、大小、边界、内部回声及后方回声.应用彩色多普勒血流成像(CDFI)观察病灶内部及周围血流分布和供应情况.结果:6例乳腺乳头腺瘤声像图表现为乳头内圆形或椭圆形低回声结节,境界清楚,后方回声增强,彩色多普勒显示结节内少量血流或边缘血流.1例位于左乳乳头后方低回声结节,边界清晰,周边见薄的包膜回声,彩色多普勒显示其内中等量的血流信号.结论:乳腺乳头腺瘤是一种少见的乳腺良性肿瘤,超声检查有助于乳腺乳头腺瘤的诊断及鉴别诊断.     

乳腺叶状肿瘤与纤维腺瘤高频超声特征的对比分析

目的:探讨高频超声对乳腺叶状肿瘤与纤维腺瘤的诊断价值。方法:对术前行高频彩色多普勒超声检查、并经手术病理证实的48例乳腺叶状肿瘤和128例纤维腺瘤的超声声像图和临床资料进行回顾性对比分析。结果:高频超声声像图显示2组在肿瘤形状、内部回声、有无钙化及无回声区、后方回声、血流信号分级方面差异均有统计学意义(均P0.05)。结论:高频超声声像图示肿块呈欠规则或不规则形,内部回声不均匀,见钙化及无回声区,后方回声增强,彩色血流分级呈Ⅱ或Ⅲ级,均视为乳腺叶状肿瘤与纤维腺瘤的鉴别要点。     

彩色多普勒超声鉴别乳腺良恶性肿瘤的临床价值

目的：研究乳腺良恶性肿瘤的声像图彩色多普勒血流的表现,探讨彩色多普勒超声在鉴别乳腺良恶性肿瘤中的实用价值。方法：对68例经病理确诊患者的声像图资料,结合病理进行综合分析。结果：乳腺良恶性肿瘤在测量值的纵横比、形态、边界、包膜、内部回声、后方衰减、回声的类型、钙化、腋窝淋巴结、血流的分级、血流形态等均存在显著差异。结论：根据乳腺良恶性肿瘤的彩超特点及病理进行综合分析,具有较高的诊断价值。     

乳腺囊内乳头状癌的声像图特征

目的:探讨乳腺囊内乳头状癌的高频声像图特征及其鉴别诊断。方法:回顾性分析11例经术后病理证实的乳腺囊内乳头状癌资料,超声观察病灶形态、大小、边界、内部回声、后方回声,以及病灶内及周围血流情况。结果:乳腺囊内乳头状癌声像图表现为边界清楚,囊壁上乳头状突起,形态不规则,基底部较宽,可有厚分隔,后方回声增强,彩色多普勒显示囊内实质结节内血流较丰富或边缘血流等特征。结论:乳腺囊内乳头状癌的超声表现具有一定的特征,有助于乳腺囊内乳头状癌的诊断及鉴别诊断。     

原发性乳腺淋巴瘤的彩色多普勒声像图分析及其价值

目的：回顾性分析11例原发性乳腺淋巴瘤的声像图表现,以提高超声对原发性乳腺淋巴瘤的认识及诊断水平。方法复习2005年-2013年来我院经活检或手术病理证实的11例乳腺原发性淋巴瘤的彩色多普勒超声表现,分析其声像图特征。结果11例患者中,10例可见具体肿块,1例表现为乳腺结构紊乱,呈弥漫性低回声而无明确肿块。乳腺淋巴瘤单发5例,多发6例。10例为低回声,1例为高回声。其中5例为形态不规则的极低回声,其内部伴有条索状强回声,肿块边界不清,后方回声多增强,彩色多普勒显示血流信号较丰富。结论乳腺团块边界欠清晰,形态欠规则的低或极低回声,内伴有条索状高回声,后方回声增强,血流丰富且肿块多发时。应考虑到乳腺淋巴瘤可能。     

皮脂腺囊肿的超声特征（附52例分析）

目的：通过分析皮脂腺囊肿的声像图特征,提高对本病的诊断水平。方法：对手术病理证实的52例皮脂腺囊肿的声像图特征进行回顾性分析。结果：52例皮脂腺囊肿声像图均表现为圆形或椭圆形低回声肿物,质软,探头加压可变形,边界清晰光滑,有完整的包膜回声,肿物后方回声有增强,内部回声不均匀,呈密集点状或粗颗粒状,大体病理呈豆腐渣样。彩色多普勒血流（CDFI）显示：肿物周边及内部无明显血流信号。结论：彩色多普勒超声在皮脂腺囊肿的诊断中具有较高的价值。     

乳腺叶状肿瘤超声特征及与病理对照分析

目的:研究乳腺叶状肿瘤的超声声像图特征,并与病理结果相对照,以期从超声角度提高对本病的认识。方法:分析经病理证实的16例乳腺叶状肿瘤的二维及彩色多普勒超声表现,并与病理结果对照分析。结果:二维图像肿块体积大小范围变化大,形态不规则可分叶,可有包膜,内部多为不均匀弱回声,可有液性暗区。CDFI良性血流0~Ⅰ级,恶性Ⅱ~Ⅲ级,阻力指数偏高。结论:乳腺叶状肿瘤的二维声像图具有一定特点,但无明显特异性,肿块的大小与良恶性之间无明显联系,结合肿块内部囊性变、彩色多普勒超声显示丰富的血流及高速高阻频谱,对提示恶性有意义。     

乳腺叶状肿瘤的高频超声特征及临床分析

目的探讨乳腺叶状肿瘤(phyllodes tumor of the breast,PTB)的高频超声特征及其鉴别诊断中的应用价值。方法分析我院32例乳腺叶状肿瘤和38例纤维腺瘤的高频彩色多普勒超声图像及病理资料,综合相关信息行鉴别诊断。结果两组患者在形态、包膜、内部回声、囊性变、后方回声等二维超声声像图特征方面比较存在显著差异,且差异具有统计学意义;而在钙化方面,两组比较无明显差异。乳腺叶状肿瘤组患者的血流分级情况与纤维腺瘤组比较存在显著差异,且差异具有统计学意义。结论乳腺叶状肿瘤高频超声表现有一定的特点,但乳腺良性、交界性与恶性叶状肿瘤的高频超声表现无明显差别,仍需进一步研究。     

彩色多普勒超声对乳腺良恶性肿块的鉴别诊断价值

目的应用彩色多普勒血流显像（CDFI）观察乳腺肿块的血流特点，评价血流参数（PSV、R0对乳腺良、恶性肿块的鉴别诊断价值。方法运用CDFI检测73例的77个乳腺肿块，并与术后病理对照。对其中超声检测出血流的60个乳腺肿块观察血流特点并进行血流参数测定，比较乳腺良、恶性肿块的差异，同时对RI诊断的敏感性、特异性、阳性预测值、阴性预测值加以分析。结果乳腺恶性肿块的CDFI血流信号较良性肿块明显丰富。恶性肿块的PSV、RI值明显高于良性肿块CP〈O．05），以RI≥0．70诊断乳腺癌敏感性和特异性较高，分别为82．6％和80．95％。结论彩色多普勒血流显像及血流参数测定对乳腺良、恶肿块的鉴别诊断具有重要的参考价值。     

三维彩色多普勒超声在乳腺良恶性肿物血管分布方面的研究

目的:应用三维彩色多普勒超声研究乳腺良恶性肿物的血管分布情况,探讨其在乳腺良恶性肿物诊断中的价值。方法:对94例由手术及病理证实的乳腺肿物患者进行三维彩色多普勒超声检查,探查乳腺供血动脉对乳腺肿物的供血情况,分析乳腺肿物的整体血管分布特征。结果:乳腺供血动脉对乳腺良恶性肿物的供血方式不同。乳腺良性肿物的血管分布形态以"球状"、"星条状"和"树枝状"三种多见,以其作为乳腺良性肿物的诊断标准,敏感性87.8%,特异性82.2%,Youden指数0.70;乳腺恶性肿物的血管分布形态以"荆棘状"、"珊瑚状"和"花环状"三种多见,以其作为乳腺恶性肿物的诊断标准,敏感性73.3%,特异性89.8%,Youden指数0.63。结论:在三维彩色多普勒成像中,乳腺良恶性肿物的血管分布形态是不同的,且有一定规律可循的。     

高频彩色多普勒超声在乳腺肿瘤诊断中的应用价值

目的探讨高频彩色多普勒超声对鉴别乳腺良恶性肿块的应用价值。方法对86例经手术病理确诊的乳腺疾病患者（56例良性,30例恶性）进行术前彩超检查,对比性分析了两组间高频声像图、彩色多普勒血流成像（CDFI）、病灶内血流Adler分级、阻力指数（RI）、峰值流速（PSV）的差异。结果乳腺良恶性肿块声像图鉴别以肿块边界及形态特征最重要,彩色多普勒显示乳腺癌内的血流较良性肿块明显丰富（P〈0．05）,乳腺癌的血管分布异常、频谱多普勒示肿块内动脉血流PSV、RI也是显著高于良性肿块且有显著性差异（P〈0．05）。结论综合分析和评价血流Adler分级及频谱多普勒各项血流动力学参数（PSV,RI）指标,有助于对乳腺良恶性肿块的鉴别。     

Imaging of the testicle: the painful scrotum and nonpalpable masses.

Scrotal pain is initially evaluated by color Doppler ultrasonography providing information on the presence or absence of flow within the testis and B Scan imaging providing important complementary information about lesions such as torsion of the appendix testis and testicular abscess. While radioisotope scanning provides similar information to color Doppler about testicular flow, it does not demonstrate the anatomy. Testicular imaging is extremely sensitive for "silent masses" and useful to evaluate palpable ones. Characteristic findings may be seen with simple testicular cysts and epidermoid cysts. Homogeneously hyperechoic masses have a variety of etiologies but are virtually always benign. A major limitation of a ultrasonography is the large number of nonneoplastic lesions which may mimic tumors.     

Imaging of the testicle: The painful scrotum and nonpalpable masses

Scrotal pain is initially evaluated by color Doppler ultrasonography providing information on the presence or absence of flow within the testis and B Scan imaging providing important complementary information about lesions such as torsion of the appendix testis and testicular abscess. While radioisotope scanning provides similar information to color Doppler about testicular flow, it does not demonstrate the anatomy. Testicular imaging is extremely sensitive for “silent masses” and useful to evaluate palpable ones. Characteristic findings may be seen with simple testicular cysts and epidermoid cysts. Homogeneously hyperechoic masses have a variety of etiologies but are virtually always benign. A major limitation of a ultrasonography is the large number of nonneoplastic lesions which may mimic tumors.     

Phyllodes tumors of the breast

Our objective was to study the color and pulse Doppler ultrasonography of phyllodes tumors of the breast. The data of 36 phyllodes tumors (19 benign, 5 borderline, and 12 malignant) were reviewed retrospectively. The median age of the patients was 41.5 years (range 13–62 years), and the tumors varied in size from 1.5 to 20 cm (median 4.6 cm). Most of the phyllodes tumors were lobulated masses with smooth margins, mildly hypoechoic internal echo texture, a heterogeneous internal echo pattern, and no microcalcification. Vessels were detectable on 35 of these tumors, with 51.4% having resistance index >0.700, 45.7% having pulsatility index >1.300, and 51.4% having V_max >15 cm/s. The color Doppler characteristics were of no significant use in predicting the histological nature of the phyllodes tumors. If the sonographic features suggest a phyllodes tumor, a histological examination should be conducted to confirm the diagnosis. Electronic Publication     

MR imaging of the breast with Gd-DTPA enhancement: comparison with mammography and ultrasonography.

The accuracy of MR imaging with Gd-DTPA enhancement was compared with mammography and ultrasonography in 52 patients with clinically palpable benign and malignant breast masses (36 carcinomas, 2 malignant phyllodes tumors, 7 fibroadenomas, 7 cysts). On dynamic MR imaging, carcinomas and fibroadenomas were discriminated by their different dynamic enhancement profiles. In carcinomas, signal intensity increased rapidly, reaching a peak or plateau within 2 min after the injection of contrast medium. In fibroadenomas, signal intensity showed a much slower continuous increase without ceasing until about 8 min after injection. Malignant phyllodes tumors showed a dynamic enhancement profile identical to that of benign fibroadenomas. MR imaging correctly identified 84% of malignant tumors, 86% of fibroadenomas, and 100% of cysts, and was substantially more accurate in tissue characterization than mammography. The results of ultrasonography were highly similar to those of MR imaging. However, no single modality was infallible, and the three modalities were complementary rather than competitive. Considering the high cost and long examination time of MR imaging, mammography supplemented by ultrasonography seems to be the method of choice in the diagnosis of breast lesions. Nevertheless, MR imaging can add important information when the results of mammography and ultrasonography are insufficient or contradictory.     

高频超声检测乳腺癌与乳腺纤维腺瘤诊断价值的探讨

目的:探讨高频超声和彩色多普勒(CDFI)对乳腺良、恶性肿瘤的形态及血流动力学特点,对鉴别良、恶性肿瘤的诊断价值。方法:应用高频超声结合CDFI技术对146例乳腺肿瘤的声像图特征及血流动力学与病理结果对照分析。结果:146例乳腺肿瘤中,乳腺纤维腺瘤90例,符合率94.4%,浸润性导管癌56例,符合率91.1%。结论:乳腺癌的特征性表现为形态不规则,毛刺状或蟹爪状,致密小钙化灶和后方回声衰减,CDFI:RI>0.75。乳腺纤维腺瘤的特征性表现为边界清晰,形态规则,有包膜和侧边声影,CDFI:RI<0.75。但是部分良、恶性肿瘤有交叉表现。     

多普勒超声诊断肾血管平滑肌脂肪瘤的价值

目的探讨彩色多普勒超声在诊断肾血管平滑肌脂肪瘤(RAL)中的应用价值.材料和方法应用二维超声、彩色多普勒血流图(CDFI)、彩色能量多普勒血流图(PDI),结合脉冲多普勒频谱对25例肾血管平滑肌脂肪瘤进行研究.结果CDFI对RAL内血流显示率36%,PDI对RAL血流显示率92%.RAL血流呈低速高阻型.阻力指数(RI)＞0.6(91.3%),动脉峰速55cm/s(86.96%).结论CDFI、PDI对RAL的诊断有重要价值.     

彩色多普勒超声诊断肾血管平滑肌脂肪瘤的临床价值(附30例分析)

目的 :探讨彩色多普勒超声在诊断肾血管平滑肌脂肪瘤 (RAL)中的应用价值。方法 :应用二维超声、彩色多普勒血流图 (CDFI) ,彩色多普勒血流图 (PDI) ,结合脉冲多普勒频谱对 30例肾血管平滑肌脂肪瘤进行研究。结果 :CDFI对RAL内血流显示率 36 % ,PDI对RAL血流显示率 92 %。RAL血流呈低速高阻型。阻力指数 (RI) >0 .6 (91.3% )、动脉峰速 ≤5 5cm/s(86 .96 % )。结论 :CDFI、PDI对RAL的诊断有重要价值。