原发甲状腺淋巴瘤的超声表现

目的 探讨原发甲状腺淋巴瘤的超声表现.方法 回顾性分析20例原发甲状腺淋巴瘤的超声表现.结果 20例原发甲状腺淋巴瘤后方回声均可见增强(100%),17例(85%)甲状腺腺体增大.13例(65%)表现为单发或多发低回声结节,边界不规则,肿瘤后方同声增强,归为结节型.3例(15%)表现为甲状腺一侧腺体增大.回声减低,后方回声增强,归为弥漫型.4例(20%)表现介于前两类表现之间,与桥本氏病表现相似,回声不均匀,片状减低,后方回声增强,归为混合型.结论 原发甲状腺淋巴瘤超声表现多样,甲状腺增大、淋巴瘤病灶后方回声增强是其主要超声特点.     

脾原发肿瘤与肿瘤样病变的超声表现

目的总结原发脾肿瘤和肿瘤样病变的超声表现以提高对脾脏疾病的认识.方法回顾性分析原发脾肿瘤19例和肿瘤样病变11例的超声表现,并与病理表现对照.结果5例原发恶性淋巴瘤表现为脾脏增大,脾内有低回声肿物或结节,边界不规则,脾门淋巴结受侵;4例脾血管肉瘤表现为脾内肿物,边界不规则,回声不一.2例脾结核表现为脾内多发边界不清的低回声结节,其余10例良性肿瘤和9例肿瘤样病变均表现为边界光整的肿物或(和)结节.结论超声在鉴别脾脏原发良、恶性病变中有一定的应用价值,肿物边界光整提示良性病变.     

原发性乳腺淋巴瘤的临床、病理及影像学特点

原发性乳腺淋巴瘤极少见,其治疗方法与乳腺癌不同,预后比乳腺癌差。该疾病的临床特点及影像学表现与乳腺癌有很大重叠,主要依靠病理诊断和分型。弥漫性大B细胞淋巴瘤是最常见的病理类型。细针针吸细胞学检查的准确率高于冷冻检查,但两者均难以完全正确诊断。临床上患者通常表现为无痛性肿块,为单个或多结节,少数患者呈弥漫浸润使乳房变硬,局部皮肤受累。原发性乳腺淋巴瘤X线表现大致可分为结节或肿块型及致密浸润型,钙化、毛刺、乳头内陷等罕见。其超声表现复杂多样,可表现为低回声或高回声,部分呈类囊肿样极低回声,伴后方回声增强或无改变,内部血流较丰富。关于乳腺淋巴瘤MRI表现的文献主要见于个案报道,表现为T1WI低信号,T2WI稍高信号,增强扫描早期明显强化,曲线以流出型多见。MRI检查在乳腺淋巴瘤诊断中的作用还不确定。     

乳腺淋巴瘤的超声图像特征

目的:回顾性分析乳腺淋巴瘤的超声和病理表现,提高超声对乳腺淋巴瘤的诊断水平。方法:复习2002~2007年经活检或手术病理证实的乳腺淋巴瘤10例的超声图文报告及病理报告,分析超声图像特征。结果:10例病理均为非霍奇金氏淋巴瘤(NHL)。乳腺肿块大小1~13cm,超声表现为单发5例,多发5例,共发现肿块17个;声像图表现为低回声肿块16个,不均匀高回声肿块1个,其中极低回声有类似囊肿样表现近似无回声肿块12个,形态不规则及不均匀肿块16个,形态规则均匀肿块1个,后方回声增强肿块17个,内部血流丰富肿块15个,多为高阻血流(2/3),伴发同侧腋窝淋巴结肿大7例。结论:肿块回声极低类似囊肿样,后方回声增强,血流信号丰富是乳腺淋巴瘤的超声图像特征,有较强的诊断价值。     

超声诊断技术在乳腺癌早期诊断中的应用及检出率分析

目的:探究超声诊断技术在乳腺癌早期诊断中的应用价值及检出率。方法:选取中国人民解放军第联勤保障部队第九六〇医院超声诊断科2021年3月—2022年3月收诊的行乳腺癌筛查的100例乳腺结节患者,予以患者超声检查,以手术病理结果为金标准,计算超声诊断准确率、灵敏度及特异度,分析良性、恶性乳腺结节超声下声像特征。结果:100例乳腺结节患者经超声检查,检出乳腺癌高危患者26例,经手术病理诊断,确诊乳腺癌患者24例,其中18例为早期乳腺癌患者,超声检查灵敏度91.67%,特异度94.74%,准确率94.00%,诊断结果与手术病理诊断具有高度一致性(Kappa=0.84);良性乳腺结节形态规则、边界清晰,结节后方回声强,无钙化灶,恶性乳腺结节形态不规则、边界模糊,结节后方回声弱,存在砂砾样钙化灶,良恶性结节病灶超声声像特征存在显著差异(P<0.05);良性乳腺结节以0级血流信号为主,恶性乳腺结节以2、3级血流信号为主,良恶性结节超声检查血流信号等级存在显著差异(P <0.05)。结论:超声诊断技术可有效鉴别乳腺结节良恶性,具有典型声像特征,乳腺癌诊断灵敏度、特异度俱佳,可作为乳腺癌早期...     

男性乳腺发育症和男性乳腺癌的X线和超声影像分析

目的:探讨男性乳腺发育症和男性乳腺癌的X线、超声征象。方法:收集2007年3月—2017年12月经手术或穿刺病理证实的13例男性乳腺发育症和6例男性乳腺癌,男性乳腺发育症患者平均年龄54.1岁,男性乳腺癌患者平均年龄57.5岁。10例男性乳腺发育症病灶触之柔软;余3例男性乳腺发育症及所有6例男性乳腺癌触之质硬,活动度差。2例男性乳腺癌初诊时即有乳头血性溢液,5例男性乳腺癌皮肤局限性或弥漫性皮肤增厚,3例伴乳头内陷。13例男性乳腺发育症患者皮肤无任何改变。1例男性乳腺癌患者其母亲有乳腺癌病史。结果:3例男性乳腺发育症表现为乳晕下区不规则肿块影,边缘不光整;其余10例均表现为中心性生长的非对称性局灶性致密影。6例男性乳腺癌均表现为单纯肿块,边界清晰锐利。其中2例为分叶形;4例为不规则形,见短毛刺。5例男性乳腺癌的乳房皮肤局限性增厚,4例乳头内陷,1例合并细小多形性钙化,局部供血血管增粗,腋窝淋巴结肿大。1例男性乳腺发育症和6例男性乳腺癌在超声上均显示为实性低回声团;其余11例男性乳腺发育症表现为腺体样回声。结论:男性乳腺发育症大部分表现为腺体样致密影,少见情况下可为孤立性结节或肿块,需与不伴特征性钙化的男性乳腺癌鉴别,超声二维成像和弹性成像可作为很好的补充。     

高频超声鉴别诊断乳腺癌和乳腺纤维腺瘤的临床价值

目的探讨高频超声鉴别诊断乳腺癌和乳腺纤维腺瘤的临床价值。方法选取行乳腺癌和乳腺纤维腺瘤治疗的患者60例,按照患者病情分为两组,乳腺癌组和乳腺纤维腺瘤组,其中乳腺癌组13例,乳腺纤维腺瘤组47例。对患者进行高频超声检查,观察乳房肿块形状、回声等超声图像。结果乳腺纤维腺瘤患者的乳房肿块形态大多数为圆形或椭圆形,肿块边缘比较圆滑,肿块内部回声情况较好,后方回声出现衰减现象较少;乳腺癌患者乳房肿块形状不规则,边缘不圆滑,肿块内部回声情况较差,分布不均匀,后方回声较差。结论高频超声检查能明确诊断乳腺癌和乳腺纤维腺瘤。     

原发性淋巴瘤的超声声像图及钼靶X线摄影特征分析

目的分析原发性淋巴瘤的超声声像图及钼靶X线摄影特征。方法回顾性分析13例经病理证实的原发性淋巴瘤患者的临床资料、超声声像图及钼靶X线摄影图像。结果 13例患者共15个病灶,9例伴有患侧腋窝淋巴结肿大,均为单侧发生非霍奇金淋巴瘤。13例患者行超声检查,9例行钼靶X线摄影检查。超声声像图多表现为:卵圆形(7/15)或分叶状(5/15)、边界清晰(10/15)低回声为主的肿块,部分肿块(7/15)伴后方回声增高,均未见肿块周围蟹足样改变、高回声晕环、后方回声衰减及肿块内钙化。多数肿块(11/15)内见丰富的动脉血流信号。钼靶X线摄影多表现为:卵圆形(5/8)或分叶状(3/8)的边界清晰(7/8)和高密度(7/8)肿块。2例乳腺腺体较致密,未见明确肿块,均未见毛刺、钙化、皮肤增厚及乳头凹陷。结论原发性淋巴瘤的超声及钼靶X线摄影表现均无特异性。在结合超声声像图肿块血流信号特征考虑恶性可能,而钼靶X线摄影表现为良性或不典型乳腺癌者应考虑到乳腺原发性淋巴瘤可能,进一步进行组织学活检以明确乳腺原发性淋巴瘤的诊断。     

原发性腮腺淋巴瘤常规超声造影表现及相关文献复习

目的探讨原发性腮腺淋巴瘤常规超声及超声造影表现。方法回顾性分析5例经病理证实的腮腺淋巴瘤的常规超声及超声造影表现,结合病理及相关文献,分析其超声表现特点。结果 5例病例,结节型4例,弥漫型1例。结节型常规超声表现为低回声,部分伴有线状高回声,单发或多发,呈椭圆或分叶状,后方回声均有不同程度增强,血流信号2～3级;弥漫型常规超声表现为腺体整体受累,腺体增大伴回声弥漫性不均匀,内见多发极低回声结节,血流信号2级;超声造影5例均表现为快进高增强,3例为均匀性增强,2例内部可见少许小片状无增强区,早期外周呈弥漫性增强,逐渐向中心增强,增强后边界较清,结节内造影剂消退迅速。结论腮腺淋巴瘤常规超声及超声造影具有一定特征,加强对本病超声图像的认识,有助于提高诊断率。     

乳腺小管癌钼靶摄影和超声的特征表现

目的 明确乳腺小管癌的钼靶摄影和超声图像的特征表现.方法 回顾性分析经术后病理证实的17例乳腺小管癌钼靶摄影和超声表现.结果 在乳腺钼靶像上17例乳腺小管癌中有15例表现为不规则形团块,边缘有毛刺.17个团块中16个团块中心致密.8例小管癌伴有钙化.声像图上见15个低回声团块,边缘不清和后方声影占93.33%(14/15).结论 小管癌在乳腺钼靶图上通常表现为不规则肿块伴中心致密和毛刺状边缘.大多数小管癌在声像图上表现为低回声团块伴边缘模糊和后方声影.尽管乳腺小管癌的钼靶摄影和超声检查不能充分鉴别小管癌与放射状瘢痕.但超声在引导活检和估计多灶和多中心性病变中有重要作用.     

Sonographic features of breast hamartomas

The sonographic features of ten breast hamartomas are reported. Four masses were clinically palpable. The mammographic appearance was characteristic of hamartomas in five cases. In the remaining five lesions, because the radiographic appearance was not pathognomonic, surgical excision was required for pathologic confirmation of the diagnosis. A wide spectrum of sonographic appearances was identified, the most frequent was that of a moderate to well-circumscribed, solid, hypoechoic mass with posterior acoustic shadowing. Two isoechoic hamartomas were very difficult to visualize on sonography. We conclude that ultrasound has a minimal role in the diagnosis of breast hamartomas, in view of their wide sonographic variability.     

Sonographic Appearances of Benign and Malignant Male Breast Disease With Mammographic and Pathologic Correlation

Objective. Imaging of the male breast is most often performed for the evaluation of a clinical abnormality such as breast enlargement or tenderness, a palpable mass, nipple skin changes, or nipple discharge. Most breast lesions encountered in men are benign. Malignant breast lesions are less frequent; breast cancer accounts for less than 1% of all male cancers in the United States. The initial imaging evaluation of a finding in the male breast is performed with mammography. Sonography is frequently used as an adjunct to mammography but is less often used as the primary imaging modality. The objective of this article is to provide readers with a thorough review of the sonographic appearances of benign and malignant male breast disease. Methods. We reviewed our institution's case database to identify male patients who underwent mammography, sonography, and subsequent biopsy of a breast lesion. These cases were collected and reviewed to select the best imaging examples. Results. A spectrum of benign and malignant male breast disease is presented with corresponding sonographic, mammographic, and pathologic imaging. For each entity, the salient imaging findings and typical clinical presentation are discussed. Conclusions. Most studies in the literature have reported on the mammographic and sonographic imaging features of primary breast carcinoma in men. However, very little has been reported on the sonographic appearance of benign and malignant male breast conditions. Recognition and correct identification of pathologic male breast entities on sonography is essential to determine appropriate management recommendations and avoid unnecessary biopsies.     

原发性甲状腺淋巴瘤的超声表现及病理特征

目的探讨原发甲状腺淋巴瘤(PTL)的超声表现及病理特征。方法回顾性分析28例经穿刺或手术病理证实的PTL患者的声像图表现,对病变的超声分型、形态特点、边界、回声及周围组织侵犯情况进行分析,并分析上述超声表现与其病理特征的关系。结果 28例PTL病例均为非霍奇金淋巴瘤,其中弥漫大B细胞淋巴瘤19例,结外边缘带B细胞淋巴瘤/低度恶性黏膜相关组织淋巴瘤6例,结外边缘带B细胞淋巴瘤伴大细胞转化3例。7例合并桥本甲状腺炎。超声示甲状腺弥漫性肿大,累及单侧或双侧,多呈不均匀极低回声,可有条索状强回声,后方回声增强,可伴数目不等的低回声结节,边界欠清,易侵犯颈部淋巴结,还可累及周围软组织、压迫气管。结论充分认识不同病理类型的PTL超声表现特点、结合病史及临床资料,有助于提高PTL的超声诊断准确率。     

Systematic approach to difficult problems in breast sonography

Although there is an increasing use of more imaging modalities in breast imaging, the role of breast sonography has not diminished--in fact, the applications of sonography have increased with the improvement of high-frequency equipment. Compared with other breast imaging modalities, current sonographic equipment has excellent spatial resolution and outstanding image contrast. Furthermore, sonography does not have the disadvantages of other modalities such as magnetic resonance imaging including exposure to intravenous contrast, higher expense, patient claustrophobia, and potential adverse contrast reaction or renal damage. The primary disadvantage of sonography is that this technique is highly operator dependent, particularly in the breast. However, if one can overcome the barrier of operator dependence, then one potentially may reduce the cost of diagnosis of breast cancers. Although many articles review sonographic appearances of solid neoplastic breast masses, relatively little attention has been directed toward subtle or confusing clinical and sonographic findings of breast cancer. This review defines methods to sonographically approach identifying vague mammographic and subtle magnetic resonance imaging lesions. Furthermore, because sonography is operator dependent, this article also involves discussing some of the pitfalls of breast sonography and how to avoid them.     

外周神经纤维瘤弥漫型的高频超声检查

目的探讨外周神经纤维瘤弥漫型的声像图特征.方法回顾性分析经病理证实的外周神经纤维瘤弥漫型患者7例,观察病变的位置、大小、形态、边界、回声特点、血流分布等.结果所有患者均表现为边界不清的皮下软组织增厚(7/7),多数病变区呈弥漫性回声增强伴多发条带状或结节状低回声(6/7),多数病变区内见大量血流信号(6/7).结论神经纤维瘤弥漫型的声像图表现具有一定特征性,结合临床表现超声容易做出正确诊断.     

乳腺黏液癌超声图像特征及误诊分析

目的探讨乳腺黏液癌的超声图像特点及超声误诊原因,以提高超声检查准确率。 方法对2010年1月至2017年1月在常州第二人民医院乳腺外科经手术病理证实的58例乳腺黏液癌患者,共60个病灶(单纯型36例,共36个病灶;混合型22例,共24个病灶)的声像图做回顾性分析,超声表现包括肿块数量、大小、边界、形态、内部回声、后方回声及肿块内部是否伴微钙化灶、肿块内部血流情况及腋下淋巴结受累情况。 结果58例乳腺黏液癌患者中有44例术前超声诊断与术后病理诊断符合,超声诊断准确率为75.9%(44/58);9例单纯型乳腺黏液癌术前超声参照乳腺影像报告和数据系统(BI-RADS)分级2～3级,其中1例误诊为脂肪瘤,2例误诊为囊肿,5例误诊为纤维腺瘤或腺病,1例误诊为导管内乳头状瘤;另外5例混合型乳腺黏液癌术前超声BI-RADS分级为5级,误诊为浸润性导管癌。 结论超声检查对乳腺黏液癌具有较高的诊断准确率。单纯型黏液癌具有良性乳腺肿块的一些声像图特征,应特别注意与乳腺良性肿块鉴别;混合型黏液癌具有浸润性导管癌的部分声像图特征,应特别注意鉴别。     

胆囊癌的超声漏误诊分析

目的：分析不典型胆囊癌的声像图特点，提高超声诊断胆囊癌的准确性。方法：对34例术前超声未明确诊断，而术后病理证实为胆囊癌病例进行回顾性分析。结果：超声误诊13例：肝癌3例，肝脓疡2例，胰头癌2例，胆道肿瘤3例，胆囊息肉2例，消化道肿瘤1例，21例漏诊，其中包括9例隐匿性胆囊癌。结论：胆囊癌有多种声像图表现，不能仅满足于胆囊炎胆囊结石的诊断，应仔细观察胆囊的界限，尤其是胆囊颈部和底部，对可疑病例应同时结合其他检查，以提高超声诊断胆囊癌的准确性。     

原发性子宫淋巴瘤超声及临床病理特征

目的总结原发性子宫淋巴瘤临床、超声及病理特征。方法对9例2002年9月至2012年9月山西医科大学附属山西省肿瘤医院收治并经手术病理确诊为原发性子宫淋巴瘤患者的临床、超声及病理特征进行总结分析。结果 9例原发性子宫淋巴瘤临床及超声表现：（1）子宫体淋巴瘤3例,其中2例以无痛性盆腔肿块就诊,1例以子宫肌瘤近期明显增大就诊;超声显示3例子宫体均弥漫性增大,子宫内膜完整,肿瘤边界清晰,后方回声均增强。（2）宫颈淋巴瘤6例,患者均以接触性出血就诊,其中4例有阴道不规则出血;超声显示4例肿瘤内为极低均匀性回声,且肿瘤边界清晰,呈分叶状;1例边界不清晰。（3）彩色多普勒血流成像示：9例中8例肿瘤病灶内血流信号增多。9例子宫切除术后病理均诊断为子宫（宫颈）原发性弥漫大B细胞非霍奇金淋巴瘤。结论阴道不规则出血或接触性出血,超声显示子宫体弥漫均匀性增大,而子宫或宫颈内膜较完整,病灶边界清晰,内为均匀性极低回声,后方回声增强者为子宫（宫颈）淋巴瘤的临床超声特征,最终仍需由病理检查确诊。     

The Tortoiseshell Pattern in One or Both Sides of the Submandibular Glands in Mucosa‐Associated Lymphoid Tissue Lymphoma Is Related to Chromosomal Aberrations and the Disease Extent

Objective. Lesions of mucosa‐associated lymphoid tissue (MALT) lymphoma in the submandibular glands are localized or a part of systemic involvement in association with chromosomal aberrations. This series was undertaken to investigate the sonographic features of MALT lymphoma in the submandibular glands and their relationships with chromosomal aberrations and the disease extent. Methods. A total of 5 patients with MALT lymphoma without Sjögren syndrome in the submandibular glands were enrolled in this series. Patients underwent sonography of the submandibular glands with a high‐resolution transducer before surgical biopsy of the main lesion. Sonographic characteristics of the lesions were described for their location, presence of a posterior echo, texture, and presence of an internal echo. Results. Sonography in all cases showed hypoechoic and solid masses with increased posterior echo enhancement. There was an arrangement of hypoechoic small compartments demarcated by hyperechoic contour lines, which had a tortoiseshell pattern. This pattern was classified into 2 types according to its location: a lesion in the right or left side and lesions in both sides of the submandibular glands, found in 3 and 2 patients, respectively. The latter 2 cases had chromosomal aberrations of t(11;18)(q23;q23) and t(12;18)(q22;q21), respectively, and were revealed as secondary organ involvement. Conclusions. The sonographic appearance of MALT lymphoma in the submandibular glands was characterized by the tortoiseshell pattern in both primary and secondary lesions. Detection of this pattern in both sides of the submandibular glands can be an indicator of chromosomal aberrations and systematic involvement of the disease.