高频彩色多普勒超声诊断小乳腺癌65例分析

目的:探讨高频彩色多普勒超声对小乳腺癌的诊断价值。方法:对经手术病理证实的65例小乳腺癌(直径<2cm)的高频二维声像图及彩色多普勒血流显像特点及血流参数阻力指数(RI)大小进行回顾性分析。结果:65例小乳腺癌(BI-RADS4级)均为单发,发生在乳腺外上象限30例(46.15%),内上象限8例(12.30%),外下象限9例(13.85%),乳晕区15例(23.08%),内下象限3例(4.62%)。病理类型:单纯癌28例,浸润性导管癌23例,髓样癌7例,腺癌5例,小叶癌2例。65例小乳腺癌高频二维声像图特征为低回声团块,多数境界清楚,边缘欠光整,无明显包膜,少数呈"蟹足样"改变。团块纵径大于横径,纵径/横径之比>1,内部回声均匀,有"点状"或"针尖样"光斑,声影不明显,彩色多普勒显示团块内部及周边"短线状"血流信号,呈动脉频谱,阻力指数RI>0.75。结论:高频彩色多普勒超声能够准确地反映乳腺肿块的特征表现,是鉴别乳腺肿块性质的重要检查方法。

Analysis on 65 cases with small breast cancer diagnosed by high-frequency color Doppler ultrasonography

Objective:To explore the value of high-frequency color Doppler ultrasonography in diagnosis of small breast cancer.Methods:The high-frequency two-dimensional sonography,imaging characteristics of color Doppler flow and resistance index (RI) of 65 cases with small breast cancer confirmed by pathological examination were analyzed retrospectively.Results:The small breast cancer (diameter<2 cm) was solitary among 65 cases,the distributions of small breast cancer included upper outer quadrant (30 cases,46.15%),upper inner quadrant (8 cases,12.30%),lower outer quadrant (9 cases,13.85%),areola area (15 cases,23.08%) and lower inner quadrant (3 cases,4.62%).Pathological types:28 cases of simplex carcinoma,23 cases of infiltrating ductal carcinoma,7 cases of medullary carcinoma,5 cases of adenocarcinoma,2 cases of lobular carcinoma.The imaging characteristics of high-frequency two-dimensional sonography were hypoechoic lumps,and most of them had clear boundary,rough edge,without obvious capsule,some of them showed crab-like changes.Longitudinal diameter of lumps was longer than transverse diameter,longitudinal/transverse diameter >1,internal echo was homogeneous,with spot-like or point-like light spot and unconspicuous sound shadow,color Doppler ultrasonography showed that intratumoral and peritumoral blood flow signals were short-linear,showing arterial spectrum,RI>0.75.Conclusion:High-frequency color Doppler ultrasonography can reflect the characteristics of breast lumps precisely,which is an important method to differentiate the character of breast lumps.