超声诊断导管型乳腺癌与乳腺导管内乳头状瘤

摘要

Objective To observe the ultrasonic features of ductal breast cancer ( DBC) and breast intraductal papilloma ( IDP) so as to explore the differential diagnosis value of ultrasonography.Methods Retrospective analysis was conducted on 62 cases of DBC undergoing color Doppler ultrasonography and confirmed by operation and pathology and 60 cases of IDP confirmed by operation and pathology and with ductal dilatation revealed by ultrasonography.Results The ultrasound diagnosis coincidence rate of DBC patients was 77.4%(48/62) with 6 cases misdiagnosed as IDP, and that of IDP patients was 91.7%(55/60) with 5 cases diagnosed with malignant lesions.DBC patients were not significantly different from IDP patients in tube diameter [(5.6 ±4.7)mm vs (5.4 ±4.1)mm] (P >0.05).There were significant differences in the aspects of courser, catheter morphology, wall echo and calcification between IDP cases and DBC cases (χ2 value was 40.831, 32.004, 31.732 and 47.550, respectively, all P<0.05).The differences in blood flow distribution surrounding catheter and inside were also significant (χ2 value was 15.756 and 25.442, respectively, both P<0.05).But blood flow grading was not remarkably different between them ( P>0.05 ) .Conclusion Catheter thickening, tiny calcification along catheter, fuzzy tube wall and irregular interrupt, stiff courser and rich blood flow signals around duct are the ultrasonic features of DBC, which has important value in differential diagnosis of DBC and IDP.%目的：通过观察导管型乳腺癌（ DBC）与乳腺导管内乳头状瘤（ IDP）的超声声像图表现特点，探讨超声对两者的鉴别诊断价值。方法对62例行彩色多普勒超声检查经手术病理证实为DBC患者及经手术病理证实为IDP且超声分型为导管扩张型的患者60例作回顾性分析。结果62例DBC患者超声诊断符合率为77．4％（48／62），6例误诊为IDP；60例IDP患者超声诊断符合率为91．7％（55／60），5例提示为恶性病变。 DBC与IDP患者乳腺癌导管内径比较[（5．6±4．7） mm VS （5．4±4．1） mm]，差异无统计学意义（P＞0．05）；DBC与IDP在导管的走行、形态、壁回声、钙化灶方面比较差异均具有统计学意义（χ2值分别为40．831、32．004、31．732、47．550，均P＜0．05）；两者血流分布中导管周边和导管内部比较差异均有统计学意义（χ2值分别为15．756、25．442，均P＜0．05），而血流分级比较则差异无统计学意义（P＞0．05）。结论导管增粗、沿导管周围有微小钙化灶、管壁模糊且不规律中断、走行僵硬且导管周围有丰富血流信号是DBC的超声特征，对鉴别DBC与IDP具有重要价值。