乳腺癌的彩色多普勒及高频超声表现(附82例分析)

目的 探讨乳腺癌的高频超声图像特征及彩色多普勒血流表现。方法回顾性分析82例经手术、病理证实为乳腺癌的高频超声表现及彩色多普勒血流特征：结果乳腺癌的高频超声图像像，如肿块的形态、边界、内部回声、钙化、衰减及彩色多普勒血流，有一定的特征。结论高频超声与彩色多普勒技术联合应用诊断乳腺癌，其诊断符合率会有一定的提高。     

颈动脉粥样硬化与脑梗死相关性的彩超研究

目的 :探讨颈动脉粥样硬化与脑梗死的关系。方法 :对 132例经CT、MRI证实的脑梗死患者和 10 4例非脑梗死患者行颈动脉彩超检查 ,测量血管的内径、内膜—中层厚度 (IMT) ,血流的速度等参数 ,观察斑块的有无及其形成情况。结果 :132例脑梗死患者中 ,颈动脉有IMT增厚、斑块形成、管腔狭窄等血管异常者占 114例 ,检出率为 86 .3% ,对照组中有IMT增厚和斑块形成 19例 ,检出率为 18.2 % ,二者比较有显著性差异 (P <0 .0 1)。结论 :脑梗死和颈动脉粥样硬化有密切的相关性 ;高分辨率彩超诊断技术能早期发现颈动脉粥样硬化 ,对预防脑梗死的发生有重要的意义。     

乳腺癌的彩超诊断价值

目的:探讨乳腺癌的彩超声像图和彩色多普勒血流成像(CDFI)表现,评价其诊断价值。方法:回顾性分析63例乳腺癌声像图资料,就其二维超声图像的特点进行分析,并对其中45例经多普勒能量图检测的病例的多普勒信号和指标进行总结。结果:高频超声的二维图像能显示乳腺癌肿块的内部呈低回声,境界不清,边缘呈多角形或蟹足样,回声衰减,纵/横比率(L/T)>1,钙化灶出现等。CDFI显示出肿块内部丰富血流,测定其动脉血流峰速大于12cm/s。结论:综合分析声像图和CDFI表现对乳腺癌的诊断具有重要价值。     

乳腺癌的超声表现与病理对比研究

1998年12月至2003年1月我院应用超声诊断乳腺癌30例，手术病理证实27例，诊断符合率为90％，现报告如下。     

甲状腺肿块8O例彩超与病理诊断对照分析

本文回顾分析了3年来用彩色多普勒实时高频超声诊断仪检出，经手术后病理诊断的甲状腺肿块80例。     

高频彩超联合X线钼靶诊断早期乳腺癌价值研究

目的:探讨高频彩色多普勒超声(CDU)联合X线钼靶检查对早期乳腺癌的诊断价值。方法:选择经术后病理检查证实的直径<2cm乳腺瘤63例,采用CDU联合X线钼靶检查,分析早期乳腺癌影像学诊断特征,并与术前单用CDU及单用X线钼靶诊断结果进行比较。结果:(1)CDU声像图大部分为低回声或偏低回声团块;肿块后方声衰减39例,肿物内强回声光斑17例;肿瘤纵横经比>1者49例;周边及内部均见短线状彩色血流信号35例,呈动脉频谱,阻力指数较高。(2)X线钼靶诊断表现为肿块影39例,肿块密度增高、边缘不整或呈分叶状14例,伴毛刺征19例。肿块内部有恶性钙化灶21例,主要为线样、小棒状、细沙样或多形性微小钙化。(3)CDU联合X线钼靶检查对乳腺癌的检出率和符合率,均分别显著高于单用CDU及单用X线钼靶检查(P<0.05);单用CDU检查的检出率和符合率虽略高于单用X线钼靶检查,但二者比较,差异不显著(P>0.05)。结论:CDU联合X线钼靶检查可显著提高早期乳腺癌诊断准确率。     

彩色多普勒超声对小乳腺癌与乳腺增生的诊断价值研究

目的研究彩色多普勒超声对小乳腺癌与乳腺增生的诊断价值。方法收集我院经手术和病理活检确诊的乳腺增生与小乳腺癌患者各73例,比较分析其病灶形态的彩色多普勒超声二维声像图特征及血流信号图特征。对各指标率的变化进行统计分析。结果小乳腺癌和乳腺增生病灶形态的二维声像图特征及彩色血流图的比较,具有统计学意义（P〈0.05）。结论彩色多普勒超声检查可以根据病灶形态及血流信号的二维声像图特征对乳腺疾病进行有效的鉴别检查。     

彩超诊断乳腺癌2例

例1 女,58岁.自觉左乳包块,查体:左乳外象限触及包块,质硬,表面光滑,轻度压痛,活动度差,左腋窝触及类圆形包块,有活动(图1).     

彩色多普勒超声诊断特殊类型乳腺癌的应用价值

目的：探讨彩色多普勒超声诊断特殊类型乳腺癌的应用价值。方法：回顾性分析7例经手术、病理证实为特殊类型乳腺癌各型的声像图及彩色多普勒血流表现。结果：炎性乳腺癌病变广泛，图像表现多样化，呈多发性或巨大肿块，内部为混合性或实性改变。双侧乳腺癌、哺乳期乳腺癌及男性乳腺癌图像有典型的恶性肿瘤特征，乳腺派杰氏病早期腺体内无局限性病灶。结论：彩色多普勒超声对炎性乳癌、双侧乳腺癌、哺乳期乳腺癌及男性乳腺癌的诊断有重要价值。乳腺派杰氏病早期确诊主要依赖于病理检查。     

48例乳腺癌的CR钼靶摄影征象与病理对照研究

目的 阐述乳腺癌的CT钼靶摄影征象及其与病理类型的相关性。方法 回顾48例行钼靶摄影及术后病理诊断为乳腺癌的临床资料，通过双盲法记录各病例的影像表现和病理类型。结果 浸润性导管癌在CR上常表现为毛刺样肿块，其次为钙化；浸润性小叶癌则表现为腺体扭曲和不对称密度；硬癌以长毛刺状肿块多见；原位癌常以微钙化为唯一的CR异常；乳腺粘液癌常表现为边界光滑肿块。结论 CR钼靶摄影是早期发现和诊断乳腺癌最有效的方法之一；乳腺癌的影像表现与其生长和浸润方式有关。     

乳腺癌超声分型与病理组织学分型的对照研究

目的:探讨乳腺癌超声分型与病理组织学分型之间的关系及临床意义。方法:对119例术后证实为乳腺癌患者术前的彩色多普勒超声声像图进行分型,并与病理分型对照,分析各型乳腺癌的超声图像特点及其与病理组织学诊断的符合率。结果:119例乳腺癌患者超声发现病灶126个,根据声像图表现分为5型:Ⅰ型(结节型)10例,病理为非浸润性癌1例,早期浸润性癌1例,混合性癌1例,浸润性癌7例,本型超声与病理诊断符合8例(80%)。Ⅱ型(团块型):ⅡA型(边界清晰型)3例,病理为髓样癌3例;ⅡB型(边缘毛糙型)104例,病理为非浸润性癌4例,早期浸润癌6例,浸润性非特殊类型癌93例,罕见型癌1例。超声与病理诊断符合率为98.1%(105/107)。Ⅰ型与Ⅱ型超声与病理诊断符合率比较差异有统计学意义(χ2=167.744,P0.01);Ⅲ型(囊实型)3例,病理为囊内乳头状癌2例,浸润性癌1例。超声与病理诊断符合2例。Ⅳ型(导管型)4例,病理为导管内原位癌1例,早期浸润癌1例,浸润性癌2例。超声与病理诊断符合2例。Ⅴ型(弥漫型)2例,病理诊断早期浸润性癌1例,浸润性导管癌1例。超声与病理诊断符合1例。结论:乳腺癌超声分型与病理分型密切相关,肿块的超声形态特点对组织学分类有提示作用。     

彩色多普勒超声在乳腺癌TNM分期中的应用

目的探讨彩色多普勒超声检查对乳腺癌TNM分期的评价能力。方法108例乳腺癌患者于术前1周内均经临床乳房触诊分期和彩色多普勒超声分期,并与术后1周内病理分期(用作金标准)相比较。结果术前彩色多普勒超声检查对TNM分期的准确率与术后病理分期无明显差异(P>0.05),而显著高于术前临床乳房触诊分期(p<0.01)。该两种方法的TNM分期准确率分别为92%和76%。临床触诊对腋淋巴结的误诊率与漏诊率分别为15%和17%,而彩超仅为5%和4.6%。结论彩色多普勒超声对乳腺癌术前TNM分期具有明显优势,且能减少术前单靠临床触诊所导致的盲目性。     

乳腺癌61例X线表现及病理对照分析

目的探讨和分析乳腺癌的钼靶X线影像特点及其病理基础,提高乳腺癌的X线诊断水平。方法回顾性分析研究61例经乳腺钼靶X线摄影检查、手术及病理证实的乳腺癌患者的X线表现。结果①61例患者中,单纯肿块41例,肿块伴钙化13例,单纯钙化8例,结构扭曲5例,结构扭曲伴钙化4例,局灶性致密影5例,磨玻璃样改变1例,阴性1例。②有钙化者多见于浸润性导管癌和导管原位癌,有肿块者多见于浸润性导管癌、粘液腺癌和髓样癌,结构扭曲者和局部致密性影多见于浸润性导管癌。结论①乳腺癌常见的X线表现为单纯肿块、钙化伴肿块、单纯钙化和结构扭曲。②浸润性导管癌占乳腺癌的大部分,乳腺癌的病理基础不同,导致了不同类型的X线表现。③X线摄影对乳腺癌有很高的诊断价值,尤其对临床检查阴性的患者,但对致密性乳腺还是有一定的局限性。     

Gray-scale and color Doppler ultrasonographic manifestations of papillary thyroid carcinoma: analysis of 51 cases

The purpose of this study is to assess the specific ultrasonic characteristics of papillary thyroid carcinoma and to determine the relative frequency of various patterns of papillary carcinoma on gray-scale ultrasonography (US) and color Doppler ultrasonography (CDU).

Methods

We retrospectively reviewed US features in 51 patients with confirmed papillary thyroid carcinoma. The features were analyzed based on tumor size, echogenicity, echotexture, boundary, margin, shape, and calcification pattern on gray-scale US imaging, and on patterns of vascularity on CDU. We obtained the relative frequency of features and classified these features into three categories: common (≥50% of lesions), less common (>10% but <50%), and uncommon (≤10%). Individual differences and combinations of features were also analyzed.

Results

In total, 67 nodules were enrolled in our study. The sizes of 76% of nodular lesions were <20.0 mm. Common US features of papillary carcinoma included: a homogeneous hypoechoic solid picture; a poorly defined boundary; an irregular margin; the absence of halo; the absence of calcifications or microcalcifications; and mixed perinodular and intranodular blood flow patterns. Less common features included: a heterogeneous hypoechoic or very hypoechoic picture; microcalcifications; a well-defined boundary; a regular margin; a halo with uneven thickness or an incomplete halo; and a taller-than-wide shape. Uncommon features included: an isoechoic picture; solid with cystic components; coarse calcifications; mixed coarse calcifications and microcalcifications; “inferno”-type blood flow; and absence of blood flow. On average, each nodule had 4.9 US features considered common, 1.8 US features considered less common, and 0.4 US feature considered uncommon. Features such as predominantly cystic composition, hyperechoic texture, and hypoechoic halo with even thickness were never found in our study. The top two common manifestations of papillary carcinoma were solid architecture and mixed perinodular and intranodular blood flow signals.

Conclusion

All lesions in our series had a predominantly solid characteristic on gray-scale US.     

原发性乳腺淋巴瘤X线表现及与病理相关性探讨

目的探讨原发性乳腺淋巴瘤钼靶X线表现特征及其与病理相关性，提高影像医师对该病的认识。方法回顾性复习27例经手术病理证实的原发性乳腺淋巴瘤，其中术前有完整钼靶X线资料的患者为14例。对该14例患者的临床、钼靶X线表现特征及病理进行了回顾性分析。患者均为女性，年龄28～56岁。右乳7例，左乳6例，双乳1例。结果14例原发性乳腺淋巴瘤中，13例为非霍奇金淋巴瘤(Non-Hodgkin lymphoma，NHL)(弥漫型12例，结节型1例)，1例为霍奇金淋巴瘤(Hodgkin lymphoma，HL)。乳腺X线片上9例表现为单乳单发肿块，2例表现为单乳多发肿块，1例为双乳多发肿块，2例表现为单侧乳腺致密浸润伴皮肤增厚。X线片上共发现18个肿块，肿块直径从0．7—5．0cm，平均直径2．6cm，其中13个肿块边缘清楚，5个肿块边缘表现为部分清楚部分不清楚，均未见毛刺、钙化或漏斗征及皮肤凹陷征等乳腺癌典型X线征象。此外，该组资料显示淋巴瘤X线表现与其组织病理学类型无相关性。结论原发性乳腺淋巴瘤的临床及影像学表现缺乏特异性，最后诊断需依靠病理学确诊。如临床乳腺检查考虑恶性且伴有腋下肿大淋巴结，而X线征象表现为良性或不典型乳腺癌者应提示除有不典型髓样癌可能外，还应考虑到淋巴瘤，及时做针吸或切取活检，有利于临床选取恰当的治疗方案。     

Ultrasonography of invasive lobular carcinoma of the breast: sonographic patterns and diagnostic value: report of 102 cases

The aim of this study was to define the ultrasonographic (US) features of the invasive lobular carcinoma (ILC). For this purpose, the clinical histories and the mammographic and sonographic findings observed in 102 patients affected by documented ILC were retrospectively reviewed, and the role and value of US in the diagnosis of palpable and nonpalpable breast tumors were evaluated. At US, five proven tumors were not visualized (sensitivity: 95%), while the remaining 97 showed sonographic images that are considered typically malignant: irregular heterogenic, hypoechoic irregular masses in 94 cases, which were associated with posterior shadowing in 87. The presence of only a posterior shadowing was observed in three cases. There were 16 subclinical tumors, and in two of the four in which a mammography showed an indeterminate lesion, US demonstrated a malignant pattern. All the palpable tumors that were not detected mammographically were demonstrated by US. In 13 of the 102 patients (12.7%), the correct diagnosis of malignancy was established by US. On the basis of the data obtained, it is felt that because of its sensitivity and high specificity for malignancy, US plays a very important role in the diagnosis of ILC, whenever in a patient with positive clinical findings, the mammography is negative or the mammographic features are equivocal.     

二维及彩色多普勒超声诊断乳腺包块的临床价值

目的：探讨二维及彩色多普勒超声诊断乳腺包块的临床价值。方法应用高频探头对85例各种原因引起的乳腺包块进行检查,所有病例均经手术及病理证实,并与超声诊断对照分析。结果85例乳腺包块经病理证实良性者32例,二维＋多普勒超声准确诊断30例,诊断符合率为93．8％;恶性者53例,二维＋多普勒超声准确诊断50例,诊断符合率为94．3％,且无论良性或恶性,二维＋多普勒超声诊断符合率均较单纯二维声像图诊断率高。结论二维声像图结合彩色多普勒检查可大大提高诊断的正确率,对乳腺疾病的早期发现及良恶性鉴别具有重要意义。     

良恶性乳腺结节钼靶X线与彩超影像特征分析

目的 分析乳腺良、恶性结节钼靶X线与彩色多普勒超声(CDUS)影像特征。方法随机选择经钼靶X线与CDUS检查并经手术病理证实的良、恶性乳腺结节(直径≤2．0cm)120例影像资料进行回顾性分析。结果120例中,良性结节40例．其病灶在X线片上多呈边缘光滑的圆形或条片状;CDUS可探及包膜回声,多表现为低、中较均质回声;彩色多普勒血流显像(CDFI)20例,可探及血流信号其中80例血流丰富。恶性结节80例血流丰富。恶性结节80例均为乳腺癌,在钼靶X线片上其病灶多数呈圆形或不规则形,70％边缘毛糙或有分叶,部分病灶内或周围可见细微钙化;CDFI示80例均探及血流信号且有70％病灶血流丰富。结论只要依据乳腺结节在钼靶X线片和CDUS的影像特征,就可以对良性与恶性进行鉴别。     

Intraductal papillary carcinoma of bilateral breasts: a case report

We report a 59-year-old woman presenting with a 2-month history of occasional bloody discharge from her right nipple and a palpable right breast mass on self-examination. The mammography revealed heterogeneously dense fibroglandular stromas of bilateral breasts, a lobulated mass in her right breast associated with faint pleomorphic microcalcifications, and, in addition, very faint focal granular microcalcifications in the left breast. Breast ultrasound revealed a lobulated and heterogeneous hypoechoic tumor with irregular margins at the right breast and a well-circumscribed tumor with heterogeneous echotexture at the left breast.