彩色多普勒超声与超声引导下穿刺活检诊断乳腺小肿块的临床研究

目的:探讨彩色多普勒与超声引导下穿刺活检诊断乳腺小肿块的临床价值。方法:乳腺小肿块168例(其中良性肿块81例,乳腺癌87例),对超声结果可疑恶性的48例乳腺肿块进行超声引导下穿刺活检,全部病例均经病理和手术证实。结果:肿块径线≤1cm的早期乳腺癌,恶性特征多不明显。肿块径线>1cm而≤2cm的早期乳腺癌,不规则形态、毛刺征、不均匀低回声、微钙化、纵横比≥0.8等恶性指标的敏感性明显增高,良恶性肿块比较,有显著性差异(P<0.05)。包膜多见于良性肿块。对于直径>1cm的早期乳腺癌CDFI可提供有价值的诊断信息。高频彩超与超声引导下穿刺活检联合应用,对乳腺小肿块诊断的准确性有显著提高。结论:对于早期乳腺癌的超声诊断,二维超声是最为重要的诊断信息来源,不均匀低回声、边界回声表现、微小钙化及穿入型血流是鉴别乳腺良、恶性肿瘤最为重要的超声征像。对于声像图特征不典型病例,应积极进行超声引导下穿刺活检,以提高早期乳腺癌的诊断率。

Diagnostic value of color doppler ultrasound and ultrasound-guided core-needle biopsyin small breast cancer

Objective:To evaluate the clinical value of the diagnoses of high-frequency color ultrasound and ultrasound-guided core-needle biopsy in small breast neoplasm.Methods: In 168 cases diagnosed with small breast neoplasm(benign tumor 81 cases,breast cancer 87 cases),48 cases with suspicious malignant mass were tested by ultrasound-guided core-needle biopsy.All cases were confirmed by pathology and surgical operation.Results:The malignant characteristic of early breast cancer was not obvious in patients with tumor with longest diameter less than 1cm.The sensitivity of shape abnormally,hair stabs of edge,the uneven light echo,tiny calcify,aspect ratio ≥ 0.8 increase sharply in the patients that the longest diameter tumor was longer than 1cm but smaller than 2cm.Benign and malignant neoplasm,the above two signs hade significant different(P<0.05).Conclusion: For the ultrasonic diagnosis of early breast cancer,2D ultrasound is the most important information source.The uneven hypo echo,border echo,tiny calcify and the penetration type blood flow are the most important ultrasound signs in the identification of benign and malignant neoplasm.For those cases whose sonogram is not significant,ultrasound-guided core-needle biopsy could increase the diagnosis rate of the early breast cancers.