【作者】 张翠； 张艳华； 程文； 郭丹阳； 王玲玲；

【Author】 ZHANG Cui;ZHANG Yanhua;CHENG Wen;GUO Danyang;WANG Linging;Department of Ultrasound,Harbin Medical University Cancer Hospital;

【机构】 哈尔滨医科大学附属肿瘤医院超声科；

【摘要】 目的:探讨超声检查联合超声引导细针穿刺活检在小乳癌(<2cm)肿块诊断中的诊断价值。方法:对69例可疑为小乳癌的患者,对其常规超声、彩色多普勒、超声引导细穿刺活检结果进行回顾性分析,以手术病理结果为金标准,对肿块的二维、彩色多普勒、细针穿刺病理结果进行对照。结果:66个患者69个乳腺肿物(<2cm),单发63例,多发3例,年龄28~66岁,平均45.4岁。病灶大小以彩超测量为准,最大径均≤2.0cm,平均1.34cm。手术病理证实恶性44个,良性25个。超声二维联合彩色多普勒观察69个病灶,以低回声、边界不清、纵横比大于1、微小簇状钙化,后方回声衰减、腋下淋巴结肿大,血流信号丰富为参考指标,怀疑恶性48个,其中5个为良性误诊为恶性,怀疑良性21个,其中2个为恶性误诊为良性,超声二维联合彩色多普勒诊断符合率为89.9%。经超声引导细针穿刺病理结果示43个为恶性,26个为良性,其中将1个良性肿物误诊为恶性,经超声引导细针穿刺结果诊断符合率为98.6%。结论:超声检查引导细针穿刺活检能显著提高乳腺小肿物的诊断率,其诊断阳性率与肿物大小,穿刺经验,穿刺针数,病变组织分型关系密切。超声检查、彩色多普勒对判断小乳癌有重要意义,彩超定位下活检能通过提高取材的准确性来提高小乳癌的诊断率,从而指导治疗和选择最佳的手术方式。更多还原

【Abstract】 Objective To assess the value of ultrasonography and ultrasound guided core needle biopsy in diagnosing small breast cancer(< 2 cm).Methods A total of 69 suspicious patie’nts with breast small masses were retrospective analyzed with ultrasonography,color Doppler ultrasonography,ultrasound-guided core needle biopsy,and the examination results were compared with post-operation pathological diagnosis.Results Sixty-six patients with sixty-nine breast masses(< 2 cm),63 cases of single and multiple 3 cases,28~ 66 years old,average 45.4 years.Using ultrasound measurement as a standard,The largest diameter≤ 2.0 cm,1.34 cm on average.The post-operation pathological results included breast cancer in 44 masses and benign breast lesion in 25 masses.69 breast masses were examined with two-dimensional ultrasound and color Doppler ultrasonography.Using low level echo,obscure boundary,aspect ratio more than 1,clusters microcalcification,posterior attenuation,rich blood flow signals as indicators,48 masses were suspected to be malignant,but 5 masses were mistaken for malignant,and 21 masses were suspected to be benign,but 2 masses were mistaken for benign.The accuracy of two-dimensional ultrasound was89.9%.The results of ultrasound-guided core needle biopsy showed that 43 breast masses were malignant and 26 masses were benign,but only one mass was mistaken for malignant,The accuracy of ultrasound-guided core needle biopsy was 98.6%.Conclusions Ultrasonography and ultrasound-guided core needle biopsy significantly improved the correct rate of small breast cancer diagnosis,the positive diagnostics rate have a close relationship with the mass size,patient experierence,the number of needle and the biopsy type of breast mass.Ultrasonography and color Doppler ultrasonography play important roles in diagnosis of small breast cancer,ultrasound-guided core needle biopsy can improve the diagnosis accuracy so as to guide therapy and choose the best way of surgery.更多还原