超声诊断乳腺癌

目的探讨二维超声及彩色多普勒超声在检查乳腺癌中的表现和特征，评价其在诊断乳腺癌中的应用价值。方法回顾性分析135例经手术及病理证实为乳腺癌患者的超声表现：包括二维声像图特征及彩色多普勒表现：肿块内部及周围的血供情况，血流峰值速度和阻力指数等血流动力学参数。结果135例乳腺癌中，乳腺浸润性导管癌128例，筛状癌3例，髓样癌1例，小叶癌原位癌2例和纤维腺瘤伴肉瘤变l例。超声所见：135例中超声发现肿块129例，大小为0．2em～3．4era不等，肿块纵横径比大于1占69％（89／129），肿块边界不整齐，约占70％（90／129），2例肿块不明显但局部可见沙粒样钙化点及局部血流信号异常。沙粒样钙化点占52．6％（70／129）；彩色多普勒发现血流信号占79．8％（103／129），频谱多普勒示血流峰值速度（PSV）为18-49ends，阻力指数（RI）为0．67～0．96，RI〉0．7占93．2％（96／103）。超声漏诊4例。结论当彩色多普勒超声在乳腺肿块内部或周围，或异常回声区内探及丰富血流信号，流速曲线显示为高速高阻时，要高度怀疑乳腺癌，彩色多普勒超声在乳腺良恶性肿瘤的诊断与鉴别诊断中发挥重要的作用。

Ultrasound diagnosis of breast carcinomas

Objective The aim of this study was to discuss the performance and character of breast carcinomas on gray scale and color Doppler ultrasound and to evaluate their value in the diagnosis of breast carcinomas. Methods Uhrasonographie images of 135 cases who were diagnosed as breast carcinoma by operation and pathology were analyzed retrospectively including the size, shape ,inner echoes of the tumors on gray scale ultrasound and blood flow parameters as PSV and RI in and at the periphery of tumors on color Doppler ultrasound. Results Among the 135 cases,128 cases were breast invasive ductile carcinoma,3cases were sifter-like careinoma, lcase was medullary carci- noma,2cases were carcinoma in the suit and lcase was fibroma with sarcomatous change. Among the 135 cases ,129 tumors were detected by ultrasound with a size of 0.3era to 3.4era. The tumors＇ axial/transverse ratio larger than 1 accounted for 69%（89/129）; irregular margin accounted for 70%（90/129）. Two tumors were not obvious on ultrasound with local sand-like calcification and abnormal blood flow signals. The sand-like calcification accounted for 51.9% （70/135）, color flow signals on color Doppler accounted for 76.3% （103/135）.The PSV was 18- 49ends,and RI was 0.67-0.96. The cases of RI〉0.7 accounted for 93.2%（96/103）. Four cases were missed by ultrasound. Conclusion If rich color flows signals with high PSV and RI are detected in or at the periphery of a tumor ,or in a lesion with abnormal echogenisity, breast carcinoma must be suspected. Color Doppler ultrasound plays an important role in the diagnosis and differential diagnosis of benign and malignant breast tumors.