乳腺肿块的超声诊断(附604例分析)

目的探讨乳腺肿块的超声诊断价值。方法对我院2007年1月～2009年12月检查的604例乳腺肿块的声像图与病理结果进行回顾性分析。结果 604例乳腺肿块术前超声诊断与病理诊断符合率84.8%(512/604)、误诊率15.2%(92/604)。乳腺囊肿符合率达到94.1%(80/85),乳腺纤维腺瘤符合率为92.2%(141/153),导管内乳头状瘤符合率仅为72.3%(73/101),良性病变总体诊断符合率为85.9%(410/4177),而恶性病变总体诊断符合率为80.3%(102/127)。恶性病变误诊为良性病变25例,其主要声像图特征:边界不清楚、内部均为低回声、血供不丰富、不伴钙化。结论超声诊断乳腺肿块具有较高的临床应用价值,良性乳腺肿块超声诊断与病理诊断符合率高于恶性病变,超声鉴别乳腺良、恶性肿块准确性较高,但部分病例仍难区别。病灶声像图不典型,检查者对少见病种声像图特点认识不足,对临床表现重视不够及对仪器性能参数调节不当等是造成恶性病变误诊为良性病变的主要原因。

Ultrasonographic diagnosis of breast tumors: analysis of 604 cases

Objective To investigate the diagnostic value of ultrasound examination in breast tumors. Methods The ultrasonography and pathological results of 604 patients with breast tumors were retrospectively analyzed. Results The ultrasonographic diagnosis was correct in 512/ 604 （84.8%） with 94.1% （80/85） accuracy in cysts, 92.2% （141/153）, and 72.3% （73/101） in intraductal papilloma. The overall diagnostic accuracy of malignantandbenigntumorswas80.3%and85.9%, respectively. 25malignancieswasmisdiagnosedasbenignwithfeaturesofill-definedboundary,low level echo,lack of blood supply or calcification. Conclusion Ultrasonographic diagnosis is more accurate in benign breast tumors. Main reasons for misdiagnosis included atypical features of some breast tumors,insufficient knowledge of ultrasonic appearances of rare breast tumors ; lack of correlation with clinical findings, and unfamiliarity with the imaging parameters.