乳腺导管内乳头状瘤：剪切波弹性成像评价乳腺病变良恶性误诊的潜在原因

摘要

PurposeTo evaluate the shear wave elastography in diagnosis of intraductal papillomas, benign or malignant breast lesions.Materials and Methods From December 2013 to December 2014, 145 female patients with 155 lesions who underwent ultrasonography and shear wave elastography in general hospital of PLA were retrospectively studied. All the lesions were confirmed by pathology via surgery or biopsy. The performance of the maximum elasticity, the mean elasticity, the minimum elasticity values and the elasticity ratio in diagnosis of benign and malignant tumors were analyzed. The portion of intraductal papillomas in misdiagnosed cases was calculated. The elasticity values of intraductal papillomas were compared with those of other breast benign and malignant lesions.ResultsAmong 155 lesions, pathology confirmed intraductal papillomas in 20 lesions, fibroadenosis in 23 lesions, fibroadenoma in 23 lesions, inflammation in 9 lesions, adenosis with fibroadenoma in 17 lesions, and breast cancer in 63 lesions. The maximum, mean, minimum elasticity values and the elasticity ratio of intraductal papillomas were (84.39±74.08) kPa, (51.33±46.36) kPa, (26.55±24.98) kPa and 2.80±2.18, respectively. The elasticity values of intraductal papillomas were between those of breast cancer and other benign lesions, and there were no statistically significant (P=0.003).ConclusionThe elasticity values of intraductal papillomas were between those of breast cancer and other benign lesions, which may be a potential reason to cause misdiagnosis using shear wave elastography to differentiate breast benign and malignant diseases.%目的：分析乳腺导管内乳头状瘤对应用剪切波弹性成像定量参数评价乳腺病变良恶性的影响。资料与方法2013年12月—2014年12月于解放军总医院超声科进行超声检查，并经穿刺活检或手术取得病理的145例女性乳腺病变患者共155个病灶进行实时剪切波弹性成像检查，获得病灶的弹性模量参数，分析弹性模量最大值、平均值、最小值和弹性比值，评价乳腺病变良恶性的诊断效能及导管内乳头状瘤在误诊病例中所占的比例，比较乳腺导管内乳头状瘤与其他乳腺良性病变及乳腺癌弹性模量的差异。结果155个病灶中，导管内乳头状瘤20个，腺病23个，纤维腺瘤23个，炎症9个，腺病伴纤维腺瘤17个，乳腺癌63个。乳腺导管内乳头状瘤的弹性模量最大值、平均值、最小值和弹性比值分别为（84.39±74.08）kPa、（51.33±46.36）kPa、（26.55±24.98）kPa、2.80±2.18，介于乳腺癌与其他良性病变之间，与乳腺癌及其他良性病变比较，差异无统计学意义（组间两两比较采用校正检验水准，P=0.003）。结论乳腺导管内乳头状瘤剪切波弹性模量值介于乳腺良恶性病变之间，可能是剪切波弹性成像技术评价乳腺良恶性病变时造成误诊的潜在原因。