【作者】 杨漪； 王桂兰； 刘秀建； 殷风华； 李博； 吕俊玲； 尹新丽； 于磊；

【Author】 Yang Yi Wang Gui-Lan Liu Xiu-Jian et al. The Fourth hospital of Hebei Medical University, The Tumor hosipital of Hebei province, Shijiazhuang, 050011

【机构】 河北医科大学第四医院河北省肿瘤医院；

【摘要】 目的:探讨小乳腺癌的高频彩超声像图特征及血液动力学特点,旨在提高超声对早期乳腺癌的诊断率,使其成为早期发现乳腺癌的有效检查方法。方法:收集2005年5月蜒 2006年5月1086例35—70岁妇女,进行乳腺高频彩超检查,同时与外科常规触诊检查和钼靶X线检查对照。超声仪器为GE 公司便携式高频彩超,探头频率10MHz,脉冲多普勒取样容积 1mm,角度校正<60°。被检者取仰卧位,对乳腺各象限依次自腺体外缘向乳头做辐射状扫查。结果:1．超声乳腺肿块检出率:1086例人群中共检查出乳腺肿块患者205例,占全部受检者的18．8％。其中手术21例,病理证实乳腺癌6例,乳癌占全部受检者0．56％,占结节病变的2．9％。6例乳腺癌中早期乳腺癌5例(原位癌和一期乳癌)占83．3％。2．乳腺癌发病年龄: 6例乳腺癌患者年龄集中于40-49岁,均在我国发病高峰年龄段。3．乳癌声像图特点及其与病理对照:6例乳癌中浸润性导管癌4例,浸润性小叶癌1例,筛状癌1例,肿块位于外上象限 4例,内上象限2例;直径≤2cm的小乳癌5例。超声发现最小肿块0．8*0．9cm。4．声像图特征:边界均不清晰,形态均不规整,呈毛刺样,内部均为低回声,2例内有砂粒样钙化及后方衰减;纵横比≥1者4例。彩色血流显示:有血流显示者(I级)2例,丰富者(Ⅱ-Ⅲ级)4例;RI>0．7者3 例。结论:随着超声设备技术的发展,其二维图像分辨力和彩色多普勒技术对低速血流及小血管检出率明显提高,进一步提高了超声对乳腺小肿块的诊断率;由于超声具有无损伤,无副作用,简便,易行,可重复性强,实时动态等特点,易被广大群众接受。二维超声可以清晰显示肿瘤大小形态及边界内部回声情况。彩色多普勒可以对肿瘤的血流动力学状态进行定性及定量分析,进一步为鉴别肿瘤良恶性提供依据,二者结合显著提高了诊断准确率,有较高临床应用价值。早发现,早诊断,早治疗是有效降低乳癌死亡率的最佳方法,在此次普查中早期乳癌占乳癌患者的83．3％。为治疗争取了保贵时间。因此定期乳腺健康普查对保证妇女健康和生命安全至关重要。更多还原

【Abstract】 Objective: To evaluate high frequency color Doppler ultrasonography image of small breast cancer and improve diagnosis capatility (accuracy). Methods; The ultrasound examination started from the border of breast gland ,with the nipple as a center, radially turns round to show the characters of the long and short axis of breast gland image .1086 cases were examined by ultrasound and mammography. 21 benign cases and 6 malignant cases were found and confirmed by surgery and pathology .2-Dimen-sional and color Doppler flow image of the malignant cases were analyzed. Results: The visual rate of breast cancer was 0.56%.The breast cancer has the special image such as irregular morphology. burrs margin, aspect ratio>1. callification and rich color image. 2 of breast cancer showed grade I blood flow, 4 of breast cancer showed grade II -III blood flow,3 of them showed RI>0.7. Conclusion: 2-Dimensional ultrasound image can show the morphology and margin of breast tumor ,and color Dopple flow image can show the dynamic chages of breast tumor .Diagnosis rate can be improved By using 2-dimensional and color Doppler ultrasound. It is important for women to have regular breast examination.更多还原