乳腺疑难肿块的超声图像与病理

目的通过对乳腺疑难肿块超声图像的分析,提高乳腺癌的诊断水平。方法经超声检查手术病理证实乳腺肿块共203例其中38例声像图难以确认其良恶性,对照手术病理进行分析。结果恶性肿块声像图误诊为良性病变的原因是在肿块的边界、形态、后方回声及血流方面有交叉重叠性;良性肿块误诊为恶性的病理结果往往不是单一的良性病变,故导致声像图错综复杂,易出现错误。乳腺导管内癌超声易漏诊;乳腺病则由于病理类型不同而和癌肿难于鉴别。结论非典型乳腺肿块超声图像易混淆,采用提高仪器分辨率、局部放大技术、结合临床触诊、推动肿块等检查手法,有助于提高肿块良恶性鉴别诊断。但仍有部分病例难以明确诊断,需进一步结合三维超声等其他检查方法,以提高诊断正确率。

Comparative analysis of pathology and ultrasonography of confused breast masses

Objective To analyze images of ultrasonographically confused breast masses in order to improve the diagnostic accuracy in breast cancer. Methods Among 203 breast masses which were confirmed by pathology, 38 cases were confused on ultrasonography. Comparative analysis between ultrasonographic image and pathology were performed. Results Malignant lesions were misdiagnosed to be benign ones due to the overlaps of margin, shape,posterior echo and the blood flow of breast masses. Benign lesions were misdiagnosed to be malignancy due to the comprehensive components pathologically. Breast intraductal carcinoma was often misdiagnosed by ultrasonography. Breast adenosis was difficult to be distinguished from carcinoma on ultrasonography due to different types of pathology. Conclusion It is diffucult to diagnose atypical breast masses with ultrasonography. It may be helptul to use high resolution ultrasonography, zoom technique and palpation methods, etc. Further techniques such as three-dimensional ultrasonography are helpful in diagnosing confused breast masses.