乳腺叶状肿瘤声像图特征及误诊分析

目的 探讨不同类型乳腺叶状肿瘤(PTB)的超声声像图特征并分析其误诊原因.方法 选取61例不同类型PTB患者乳腺肿块的位置、大小、数目、形态、回声等形态学特征,对比超声检查确诊PTB以及误诊患者声像图特征,并与病理结果对照分析,总结误诊原因.结果 1)本组PTB 61例,良性43例(70.5％),交界性10例(16.4...

Ultrasonographic features and misdiagnosis of phyllodes tumour of the breast

Objective To investigate the ultrasonographic features of phyllodes tumour of the breast(PTB)and to analyze the misdiagnosis reason.Methods In this work,the position,size,number and morphology of breast masses in 61 patients with different types of PTB were analyzed retrospectively.We analyzed the ultrasonic characteristics of PTB diagnosed and misdiagnosed by ultrasound,compared with pathological results,and summarized the causes of misdiagnosis.Results 1)Among the 61 PTB patients,43(70.5%)were benign,10(16.4%)were borderline,8(13.1%)were malignant,and 1(0.16%)was associated with axillary lymph node metastasis.The mean maximum diameter was(3.0±1.42)cm in the benign group and(5.5±1.33)cm in the borderline/malignant group,and the difference between the two groups was statistically significant(P<0.01).The diagnostic accuracy of PTB in borderline/malignant group was significantly higher than that in benign group(P<0.05).The tendency of BI-RADS system to distinguish benign from malignant masses was statistically significant(P<0.01);2)Among the 61 cases,19 cases were diagnosed with PTB by ultrasonic examination,with an accuracy rate of 31.10%(19/61),and 42 cases were misdiagnosed with a misdiagnosis rate of 68.90%(42/61).The proportion of PTB group diagnosed by ultrasound with a mass larger than 3 cm was significantly higher than that misdiagnosed as fibroadenoma,breast cancer and uncertain mass(P<0.05).The mass sonogram was mainly characterized by lobules/fusion,uneven echo,accompanied by dark area,and enhanced posterior echo,while the posterior echo attenuation and calcification were rare(P<0.05).Misdiagnosed as adenoma,the mass was mostly small in size,regular in shape,homogeneous in echo and few in separation(P<0.05),and the blood flow distribution was mainly grade 0~I.The tumors were misdiagnosed as cancer with irregular polymorphic morphology and uneven echo(P<0.01),and the blood flow distribution was dominated by grade II~III.The lumps in the uncertain group had both features of adenoma and cancer.Conclusion The possibility of PTB should be considered in older female with large mass,irregular shape,uneven echo,enhanced echo and rich blood flow.However,the differential diagnosis of PTB by ultrasonographic features still needs further study.