乳腺微小癌超声误诊原因分析

目的探讨乳腺微小癌(minimal breast carcinoma,MBC)的超声误诊原因。方法对我院收治的经术后病理检查确诊的MBC 90例的临床及超声检查资料进行回顾性分析。结果 90例MBC超声诊断正确58例,误诊32例;20例误诊为乳腺纤维瘤,10例误诊为小叶增生,2例误诊为乳腺腺病。肿物最大径0.5~1.0 cm 55例,超声诊断正确37例,误诊18例,超声诊断正确与误诊患者肿物的边缘、微钙化情况比较差异有统计学意义(P0.05);肿物最大径≤0.5 cm 35例,超声诊断正确21例,误诊14例,超声诊断正确与误诊患者肿物的纵横比、结节数目情况比较差异有统计学意义(P0.05)。超声误诊32例中肿物最大径0.5~1.0 cm与≤0.5 cm患者肿物的边缘情况比较差异有统计学意义(P0.05)。结论 MBC超声检查肿物最大径0.5~1.0 cm时表现为边缘清晰及无微钙化等良性结节声像图特征时易误诊;肿物最大径≤0.5 cm时表现为纵横比1及多发结节声像图特征时易误诊。

Analysis on the Causes of Misdiagnosis of Ultrasound in Minimal Breast Carcinoma

Objective To investigate the causes of misdiagnosis of minimal breast carcinoma （ MBC） by ultrasound. Methods We retrospectively reviewed the clinical and ultrasonic data of 90 cases of MBC which confirmed by pathology. Re-sults Among the 90 cases, 58 cases were diagnosed accurately, and 32 cases were misdiagnosed. Twenty cases were misdi-agnosed as having breast fibroadenoma, ten cases were misdiagnosed as having lobular hyperplasia, and two as having adenosis of the breast. The range of largest diameter of tumors was 0. 5-1. 0 cm in 55 cases, among whom, 37 were diagnosed correc-tively by ultrasound, and 18 were misdiagnosed, and there were significant differences of edges and microcalcification signs between the two groups（P〈0. 05）. There were 35 patients with tumor diameter less than or equal to 0. 5 cm, among whom, 21 were diagnosed correctively by ultrasound, and 14 were misdiagnosed, and there were significant differences of aspect ratio and nodule number between the two groups （P〈0. 05）. The tumor edges in patients with different tumor diameters （0. 5-1. 0 and ≤5 cm） showed significant difference （P〈0. 05）. Conclusion The nodules of MBC patients showing diameter of 0. 5-1. 0 cm, clear edges and no calcification in ultrasound may be easily misdiagnosed. Furthermore, multiple nodules with diam-eter less than or equal to 0. 5 cm and aspect ratio less than 1 were also easily misdiagnosed.