Objective To evaluate the value of high frequency ultrasonography in diagnosis of breast carcinoma in situ (CIS) . Methods Forty - three cases of breast CIS and 30 cases of mammary gland hyperplasia ( adenosis) confirmed by surgical pathology were enrolled in this study. Their ultrasonographic features including boundary, internal echo,microcalcification, posterior echo, peak systolic velocity( PSV) and resistance index( RI) were analyzed. Then the results was compared with mammography and pathology. Results The ultrasonographic features of breast CIS showed 55.81％ ( 24/43) of mass type, 30. 23％ ( 13/43) of sheet hypoechoic type, 9. 30％ ( 4/43 ) of duct dilatation type and 4. 65％ ( 2/43 ) of microcalcification type, respectively. There were 7 cases of ductal CIS with microinvasion, including 1 case with axillary lymph node metastasis. 34 cases of breast CIS and 24 cases of mammary gland hyperplasia were diagnosed correctly by preoperative ultrasonography, the accuracy, specificity and sensitivity were 79. 45％ , 80. 00％ and 79. 07％ respectively. The positive predictive value and negative predictive value were 85. 00％ and 72. 73％ respectively. There was significant difference of microcalcification and RI hetween breast CIS and mammary gland hyperplasia ( P ＜ 0. 05 ) . Conclusion The ultrasonic characteristics of breast CIS has certain features, and high frequency ultasonography has important value in diagnosis of breast CIS.%目的 探讨高分辨率超声诊断乳腺原位癌的价值.方法 分析我院经手术病理证实的43例乳腺原位癌患者(原位癌组)和30例乳腺增生(腺病)患者(良性组)的声像图特征,包括边界、内部回声、微钙化、后方回声、峰值血流速度、阻力指数等,并与钼钯检查结果、术后病理结果进行对比分析.结果 乳腺原位癌的声像图特征表现为肿块型、片状低回声型、导管扩张型、单纯微钙化型,分别占55.81%(24/43)、30.23%(13/43)、9.30%(4/43)、4.65%(2/43).7例(16.28%)伴有微浸润,均为导管原位癌,其中1例伴有腋窝淋巴结转移.术前超声正确诊断原位癌34例,乳腺增生 24例,其准确性、特异性和敏感性分别为79.45%、80.00%和79.07%.阳性预测值和阴性预测值分别为85.00%和72.73%.原位癌组与良性组的微钙化数、阻力指数比较差异有统计学意义(P<0.05).结论 乳腺原位癌的声像图特点具有一定特征性,高频超声检查对诊断乳腺原位癌有重要价值.
展开▼
