彩超对鉴别良恶性乳腺肿块的诊断价值探讨

目的探讨彩超对鉴别良恶性乳腺肿块的诊断价值。方法选择2009年9月-2012年4月来我院就诊的乳腺肿块患者50例;采用GE VIVID E9彩色多普勒超声仪，观察肿块的部位、形态、边界、包膜、内部回声、有无后方衰减、侧方声影，并应用CDFI观察肿块内部及周边血流，应用脉冲多普勒血流显像（Pw）检测动脉收缩期血流峰值（PSV），阻力指数（RI）。结果经术后病理证实，良性肿块共40个，其中乳腺纤维瘤19个，乳腺增生20个，脂肪瘤1个;22个恶性肿块经病理证实，其中浸润性导管癌11个，导管内乳头状癌6个，导管内癌2个。黏液癌1例，原位癌2个。与良性组比较，恶性肿块的PSV、RI值高于良性肿块（P〈0.05），且两组的血流分级也存在差异性。结论彩色多普勒超声对乳腺良恶性肿块的诊断具有一定的价值，同时结合二维声像图特点以及临床表现来作出诊断，将会进一步提高超声对乳腺癌的诊断率。

The diagnostic value of ultrasound for malignant and benign breast lumps

Objective To investigate the diagnostic value of ultrasonography in differentiating benign and malignantbreast masses. Methods From September 2009 to April 2012 in our hospital, 50 patients with breast lumps by GEVIVID E9 color doppler ultrasound system, parts of the observed mass, shape, boundary capsule, internal echo, withoutrear attenuation, the side acoustic shadow, horizontal and bilateral axillary lymph node enlargement, and color dopplerflow imaging （CDFI） observed within the tumor and the surrounding blood flow, application pulse doppler flow imag-ing （PW） measured artery peak systolic （PSV）, resistance index （RI）. Results Pathologically confirmed benign mass-es of 40, which adenofibroma 19,20 breast hyperplasia, 1 lipoma fat layer exploration and hyperechoic nodules, edgedue to regular, non-enveloped, yet uniform internal echo; 22 malignant tumors confirmed by pathology, included 11invasive ductal carcinoma, intraductal papillary carcinoma in 6 a ductal carcinoma. Mucinous carcinoma 1 cases, car-cinoma two cases. Compared with benign, malignant tumor PSV, RI values were higher than benign tumors {P 〈 0.05）,and two sets of flow grade there were also differences. Conclusion Color doppler ultrasound diagnosis of benign andmalignant breast tumor has a certain value, combined with the two-dimensional sonographic features and clinical man-ifestations to make a diagnosis, and will further enhance the rate of ultrasonic diagnosis of breast cancer.