超声及钼靶X线检查对乳腺实性神经内分泌癌的诊断价值

摘要

目的 观察乳腺实性神经内分泌癌( neuroendocrine carcinoma,NEC)的超声及钼靶特征,初步探讨超声及钼靶X线检查对这一少见病理类型乳腺癌的诊断价值.方法 从随访677例乳腺癌病例中,抽取6例NEC患者的超声和钼靶影像资料,结合文献,回顾性分析6例经病理反馈证实的NEC超声和钼靶X线表现.结果 超声显示6例均为低回声、分布均匀、无钙化,5例后方回声增强,1例无改变；4例形态规则、有包膜,2例形态欠规则,纵横比＞1、包膜不完整；CDFI血流模式:Ⅰ型血流1例、Ⅲ型血流2例、Ⅲ型血流3例；BI-RADS评分:3级4例(初步确定良性)、BI-RADS评分4A级1例(良恶不确定)、BI-RADS 5级1例(恶性)；乳腺X线钼靶摄影:6例可见类圆形高密度影、边界清、无钙化,1例周围隐约见星芒状改变；术前提示:良性肿块3例、良恶不确定1例、恶性2例.结论 原发性NEC的超声和钼靶X线影像学诊断均比较困难,缺乏典型恶性肿瘤影像学表现,须与纤维腺瘤或髓样癌等鉴别.%Objective To observe the character of Ultrasound and mammography in solid neuroendocrine carcino-ma(NEC) of breast cancer; discuss the diagnostic value of Ultrasound and mammography in the rare pathological type of breast cancer preliminarily. Methods We selected Ultrasound and mammography information of all 6 NEC cases from 677 Breast cancer cases, and analyzed retrospectively the expression of Ultrasound and mammography of these 6 cases confirmed pathologically. Results Ultrasound:6 cases are hypoechoic and well-distributed,in which 5 cases with echo enhancement in the rear, 1 case with no change and all with no calcification. Shape of 4 cases is regular and enveloped; Shape of 2 cases is relatively irregular and enveloped incompletely, whose aspect ratio is above 1. CDFI blood flow patterns : 1 case is type I flow, 2 cases are type Ⅱ flow and 3 cases are type Ⅲ flow. BI-RADS score: 4 cases are 3-class (preliminary identification of benign) , 1 case is 4A- class (uncertain benign or malignant) , and1 case is 5-class (malignant). Breast X-ray mammography: 6 cases are round with high density shadow, clear bounder and no calcification. 1 case has vague satellite-shaped changes around it. Indication before surgery: 3 cases are benign tumor. 1 case is uncertain in benign or malignant and 2 case is malignant. Conclusions The diagnosis of preliminary NEC is more difficult by Ultrasound and mammography, which is lack of typical imaging features of malignant lesions, and need to be differentiated from fibroadenoma and medullary carcinoma.