乳腺叶状肿瘤超声表现与病理相关性研究

  目的  分析乳腺叶状肿瘤的超声特点，以提高对该病的认识。  方法  按照美国放射学院（American College of Radiology，ACR）乳腺超声BI-RADS诊断标准，回顾性分析天津医科大学肿瘤医院85个乳腺叶状肿瘤的超声图像及病理资料。  结果  85个叶状肿瘤中良性33个、交界性28个和恶性24个。肿物形态多呈分叶状、边界清晰、边缘光滑、内部回声不均匀。其中良性叶状肿瘤边界清晰更为常见（χ2=12.721，P=0.002）；恶性叶状肿瘤内部多可见囊性无回声区（χ2=9.677，P=0.046）。彩色血流成像显示:75.3%（64/85）的肿物内部探及Ⅱ~Ⅲ级血流信号。26个病变进行了弹性成像，88.5%（23/26）的肿块弹性成像评分为2~3分。  结论  乳腺叶状肿瘤的超声表现具有一定特征，肿块边界是否清晰和肿块内部是否存在小囊性无回声区是鉴别良恶性叶状肿瘤的重要依据。 

Correlation between ultrasonic appearance and pathology of phyllodes tumors of the breast

  Objective  This study aims to evaluate the sonographic features of phyllodes tumors of the breast (PTBs) and the correlation between sonographic and pathologic findings to improve the understanding of the disease.  Methods  Sonographic findings of 85 PTBs from 83 patients were reviewed. The sonographic findings included the results of two-dimensional ultrasound and color Doppler flow imaging, elastographic features, and pathologic data.  Results  Of the 85 lesions, 33 were the benign tumors, 28 were borderline, and 24 were malignant according to the pathologic diagnosis. Tumor morphology revealed that most masses were lobulated, with a clear-cut boundary, smooth verge, and inhomogeneous internal echo. Clear boundary was more common in the benign phyllodes tumors (χ2=12.721, P=0.002), and a cystic echo-free area was more commonly observed in these malignant tumors (χ2=9.677, P=0.046). Level Ⅱ and Ⅲ signals of the blood flow were observed in 75.3% of PTB cases. Of all lesions, only 26 were subjected to elasticity imaging, and the elastographic scores ranged from 2 to 3 in 88.5% of the cases (23/26).  Conclusion  Conventional ultrasound and elastographic findings on PTBs exhibited definite characteristics. The border and cystic areas in the tumors can be used to differentiate between benign and malignant PTBs.