彩色多普勒超声在乳腺小肿块良恶性鉴别诊断中的应用价值

目的 探讨乳腺小肿块（直径〈2cm）的超声表现特征及彩色多普勒超声对其良恶性的鉴别诊断价值。方法 64例乳腺小肿块经手术病理证实，其中恶性肿块27例，良性肿块37例。分析乳腺小肿块患者的彩色多普勒超声表现特征，应用彩色多普勒血流显像（CDFI）观察其血流分布特征，频谱多普勒检测血流参数阻力指数（RI）的大小。结果 乳腺小肿块良性组和恶性组的形态、边界包膜、纵横比及内部有无微小钙化比较，差异有统计学意义（P〈0．05）。恶性肿块血流分级≥Ⅱ级，RI〉0．7，血流频谱表现为峰值前移，舒张末期无血流信号或可见反向血流；良性肿块血流分级多为0-I级，RI〈0．7，血流频谱表现为以静脉血流频谱为主。9例恶性肿块伴有同侧腋窝淋巴结肿大，2例良性肿块为反应增生肿大。结论 彩色多普勒超声对乳腺小肿块良恶性的鉴别诊断具有重要价值，结合声像图特征和CDFI表现能有效诊断。

Application value of color Doppler ultrasound in differential diagnosis of small breast mass

Objective To explore the ultrasonic appearance characteristics of small breast mass （diameter 〈 2 cm）, and to evaluate its clinical value in differential diagnosis of benign and malignant lesions. Methods Sixty - four cases of small breast mass were confirmed by surgery and pathology, 27 of them were small breast cancer, and 37 were benign. The color Doppler ultrasonic appearance characteristics of all the patients were analyzed, their blood distribution characteristics were observed by CDFI, the blood flow parameter RI was detected by pulse wave Doppler. Results There was significant difference of shape, boundary, L/T ratio and mierocalcification between malignant and benign lesions （P 〈 0.05 ）. CDFI showed that blood classification ≥ level II ,RI 〉 0.7 were in malignant lesions. The Doppler frequency spectrum analysis showed the peak value antelocation, no blood signal or reverse blood flow direction could be found in the end diastolic phase. The blood classification in level 0 -I , RI 〈 0. 7 were found in benign lesions. Lymphadenectasis was found in 9 malignant lesions, and lymph node reactive hyperplasia was found in 2 benign lesions. Conclusion Color Doppler ultrasound has important value in differential diagnosis of benign and malignant small breast cancer.