38例乳腺癌的彩色多普勒超聲診斷價值分析

陳靈麗

[摘要] 目的 探討彩色多普勒超聲診斷乳腺癌的臨床價值。 方法 回顧性總結分析2009年1月～2012年1月筆者所在醫院收治的38例乳腺癌患者超聲聲像圖特征。 結果 38例乳腺癌患者形態不規則，呈“蟹足樣”改變28例，邊緣不光滑，呈毛刺樣改變，腫塊多為低回聲，可見細沙粒樣鈣化灶（共16例）。后方回聲衰減10例，CDFI顯示縱橫比≥1共8例。血流分級：0級3例，I級9例，Ⅱ級10例，Ⅲ級14例，檢出率為94.7％，2例未見血流信號。腋窩淋巴結腫大8例（21.1％）。 結論 彩色多普勒超聲檢查能清晰顯示乳腺癌的大小、形態、內部結構及血流分布情況，因此，彩色多普勒超聲可以作為診斷乳腺癌的常用手段之一，值得推廣和應用。

[關鍵詞] 乳腺癌；彩色多普勒超聲；診斷價值

[中圖分類號] R737.9???[文獻標識碼] B???[文章編號] 2095-0616（2012）15-110-02

Diagnostic value of color doppler ultrasound in 38 cases with breast cancer

CHEN?Lingli

Department of Ultrasound,Yima Coal Industry Group Company General Hospital of Henan Province, Yima 472300,China

[Abstract] Objective To investigate the clinical value of color Doppler ultrasound diagnosis of breast cancer. Methods Sonographic features of 38 patients with breast cancer of in our hospital from January 2009 to January 2012 were retrospectively analyzed. Results 38 patients with breast cancer morphology was irregular. 28 cases were crab-like change.The edge was not smooth, and had burr-like changes. Mass is mostly hypoechoic.16 cases had visible fine sand-like calcification. 10 cases were posterior echo attenuation. CDFI display aspect ratio of 8 cases was higher than one. Flow grade was as follows. 3 cases were grade 0.9 cases were grade Ⅰ.10 case were grade Ⅱ.14 cases were gradeⅢ. The detection rate was 94.7%, and 2 cases had no blood flow signals.8 cases were axillary lymph nodes(21.1%). Conclusion Color Doppler ultrasound examination can clearly show the distribution of breast cancer size, shape, internal structure and blood flow.Color Doppler ultrasound can be used as a common means of diagnosis for breast cancer, and it is worth of the promotion and application.

[Key words] Breast cancer;Color doppler ultrasound;Diagnostic value

近年來，乳腺癌在我國已經成為女性常見的惡性腫瘤之一，其發病率和死亡率均位于女性腫瘤的前3位[1]。尋找一種操作方法簡便、可重復性強、效果可靠、價格相對較低且診斷準確率較高的方法，對于乳腺癌的早期診斷具有重要的臨床價值[2]。彩色多普勒超聲對乳腺癌的診斷體現了較好的優勢，彩色多普勒超聲檢查對乳腺癌的診斷起著越來越重要的作用[3]。本研究回顧性分析了38例乳腺癌患者的彩色多普勒超聲的超聲聲像圖特征，旨在為乳腺癌的診斷與鑒別診斷提供有價值的依據，現報道如下。

1?資料與方法

1.1?一般資料

選擇2009年1月～2012年1月于筆者所在醫院手術且術后經病理檢查確診的38例乳腺癌患者，年齡28～72歲，平均（46.5±3.1）歲。均為單側，其中左側20例，右側18例。腫塊大小1.7 cm×2.4 cm～7.2 cm×8.1 cm。

1.2?檢查方法

使用Philips HD Evensior彩色多普勒超聲診斷儀，探頭頻率3～12 MHz。患者取仰臥位，或根據需要取側臥位，雙臂上舉稍外展，充分暴露乳房和腋窩，以乳頭為中心做放射狀掃查，觀察腫塊的大小、位置、形態邊界、有無鈣化。并應用彩色多普勒血流顯像（CDFI）觀察腫塊內部及周邊血流，應用脈沖多普勒血流顯像（PW）測血流速度及阻力指數。血流檢測包括腫瘤彩色血流信號分級及頻譜血流參數，腫塊血流分級采用Adler標準[4]：0級：病灶內無血流；Ⅰ級：少量血流病灶內1～2個點狀或細棒狀血管；Ⅱ級：中量血流，可見34個點狀血管或1條重要血管，其長度可接近或超過病灶半徑；Ⅲ級：豐富血流，見5個以上點狀血管或2條較長血管或彌漫性網狀血管，記錄病灶彩色多普血流阻力指數。同時檢測腋下有無淋巴結腫大，分析淋巴結腫大的形態及結構特征。