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摘 要 目的：探讨彩色多普勒超声在鉴别乳腺良、恶性肿块中的诊断价值。方法：对门诊42例乳腺肿块患者进行彩色多普勒超声检查，随访术后病理结果，回顾性分析乳腺良、恶性肿块彩色多普勒超声表现特点。结果：42例门诊超声检查乳腺肿块患者术后病理诊断，良性病变14例，恶性乳腺癌28例，诊断符合率分别为78.6%，89.3%。肿块形态不规则、边缘不清晰、内部回声不均匀、后方回声伴衰减、微钙化、纵横比>1.0、动脉血流的收缩期峰值流速>20 cm/s、阻力指数>0.7是鉴别恶性肿块的超声特征，准确率在57.1%?81.0%。结论：乳腺良、恶性肿块彩色多普勒超声表现有一定的特征，彩色多普勒超声检查能协助乳腺良、恶性疾病的鉴别及乳腺癌的早期诊断。
关键词 彩色多普勒超声 乳腺肿块 乳腺癌 鉴别诊断
1006-1533（2013）12-0035-03
Value of diagnosis of the ultrasound examination of benign and malignant breast masses
GAO Xuehua
（Baiyu Community Health Service Centre of Putuo District， Shanghai 200063， China）
ABSTRACT Objective： To investigate the value of color Doppler ultrasound in differential diagnosis of benign and malignant breast masses. Method： Forty-two outpatients with breast masses in the outpatient department were examined with color Doppler ultrasound， whose postoperative pathological results were followed up and the manifestation features of the benign and malignant breast tumors shown in color Doppler ultrasound were retrospectively analyzed. Result： Of postoperative pathological diagnosis of 42 cases with breast masses examined with ultrasound， 14 cases had benign lesions， and 28 cases malignant breast cancer， whose diagnostic accordance rates were 78.6% and 89.3%. The accuracy rates were between 57.1- 81.0%. Conclusion： The manifestations of benign and malignant breast tumors shown in the color Doppler ultrasound he certain characteristics. Color Doppler ultrasound can assist the differential and early diagnosis of benign and malignant breast disease.
KEY WORDS color Doppler ultrasound； breast mass； breast cancer； differentiated diagnosis
乳腺良、恶性病变，如乳腺小叶增生、炎症、乳腺纤维腺瘤、乳腺癌等是肿块的常见原因。乳腺癌是最常见的乳腺恶性肿瘤，是乳腺导管上皮及末端导管上皮发生的恶性肿瘤。近年来，我国乳腺癌的发病率正逐年上升，位居女性恶性肿瘤的第二位，对乳腺癌的早期诊断直接关系到该病的治疗和预后。本研究对门诊42例乳腺肿块患者随访术后病理结果，分析其彩色多普勒超声声像图资料，探讨超声对乳腺良恶性肿块的诊断价值。
2 结果
源于：论文的标准格式范文www.udooo.com
关键词 彩色多普勒超声 乳腺肿块 乳腺癌 鉴别诊断
1006-1533（2013）12-0035-03
Value of diagnosis of the ultrasound examination of benign and malignant breast masses
GAO Xuehua
（Baiyu Community Health Service Centre of Putuo District， Shanghai 200063， China）
ABSTRACT Objective： To investigate the value of color Doppler ultrasound in differential diagnosis of benign and malignant breast masses. Method： Forty-two outpatients with breast masses in the outpatient department were examined with color Doppler ultrasound， whose postoperative pathological results were followed up and the manifestation features of the benign and malignant breast tumors shown in color Doppler ultrasound were retrospectively analyzed. Result： Of postoperative pathological diagnosis of 42 cases with breast masses examined with ultrasound， 14 cases had benign lesions， and 28 cases malignant breast cancer， whose diagnostic accordance rates were 78.6% and 89.3%. The accuracy rates were between 57.1- 81.0%. Conclusion： The manifestations of benign and malignant breast tumors shown in the color Doppler ultrasound he certain characteristics. Color Doppler ultrasound can assist the differential and early diagnosis of benign and malignant breast disease.
KEY WORDS color Doppler ultrasound； breast mass； breast cancer； differentiated diagnosis
乳腺良、恶性病变，如乳腺小叶增生、炎症、乳腺纤维腺瘤、乳腺癌等是肿块的常见原因。乳腺癌是最常见的乳腺恶性肿瘤，是乳腺导管上皮及末端导管上皮发生的恶性肿瘤。近年来，我国乳腺癌的发病率正逐年上升，位居女性恶性肿瘤的第二位，对乳腺癌的早期诊断直接关系到该病的治疗和预后。本研究对门诊42例乳腺肿块患者随访术后病理结果，分析其彩色多普勒超声声像图资料，探讨超声对乳腺良恶性肿块的诊断价值。
1 对象与方法
1.1 对象
收集2010年6月-2012年12月我中心门诊超声检查乳腺肿块患者42例，均为女性，年龄33～83岁，平均年龄（56.8±12.9）岁。以扪及肿块或体检发现肿块以求进一步检查证实就诊，全部病例术前均行超声检查，术后均有病理诊断结果。1.2 方法
仪器采用日立 EUB-5500型彩色多普勒超声诊断仪，探头频率7?10 MHz。根据具体情况调整深度、增益、聚焦部位，使图像达到最佳效果。患者取仰卧位，充分暴露，先右后左，按照顺时钟方向，以为中心放射状进行多切面扫查，特别注意扫查后方及腺体边缘。先于二维声像图观察肿块的位置、形态、内部回声、包膜，后方回声有无衰减、纵横比（L/T）、肿块内有无钙化灶等。然后，采用彩色多普勒血流成像（CDFI）观察肿块内部及周边的血流情况。最后，采用频谱多普勒（PW）探测肿块内的血流频谱，测量动脉血流的收缩期峰值流速（PSV）和阻力指数（RI）。1.3 统计学分析
用SPSS 13.0统计软件进行x2检验，以P<0.05为差异有统计学意义，计算各超声征象的灵敏度、特异性和准确率。2 结果
2.1 乳腺肿块的病理类型及超声检查结果
42例门诊超声乳腺肿块患者术后病理诊断结果：乳腺癌28例，其中浸润性导管癌24例，导管内癌4例；良性病变14例，其中乳腺小叶增生2例，纤维腺瘤7例（包括纤维腺瘤伴钙化5例），炎性肉芽肿3例，导管内状瘤2例。右乳肿块24例，左乳肿块18例；外上象限20例，外下象限7例，内上象限8例，内下象限3例，及部4例；肿块大小（9～42）mm×（2～21）mm不等。28例恶性肿块，超声检查BI-RADS-US分级：2级3例，3级3例，42例，4b级5例，4c级7例，5级8例。超声诊断正确25例，诊断符合率89.3%，3例误诊为良性，其中2例超声检查为纤维腺瘤伴钙化，术后病理诊断为浸润性导管癌，1例超声检查为乳腺小叶增生，术后病理诊断为导管内癌；14例良性肿块，BI-RADS-US分级，2级4例，3级7例，4级3例，超声诊断正确11例，诊断符合率78.6%，3例误诊为恶性，术后病理诊断2例为炎性肉芽肿，1例为导管内状瘤。源于：毕业论文总结www.udooo.com