彩色多普勒超聲對乳腺髓樣癌與乳腺纖維瘤的診斷價值

林燕明

[摘要] 目的 探究乳腺髓樣癌和乳腺纖維瘤診斷中應用彩色多普勒超聲的價值。方法 回顧性分析2016年5月—2018年5月福建省三明市永安總醫院三明市第二醫院超聲影像科手術后經病理證實的乳腺髓樣癌患者50例為實驗組，同時選取乳腺纖維瘤患者50例為對照組，對病灶的二維及彩色多普勒聲像圖特征包括病灶的形態、邊界、內部的回聲、腋窩淋巴結轉移及彩色血流的特點分析，比較其差異性。 結果 實驗組診斷符合率為86.00%，對照組診斷符合率為94.00%;實驗組病灶邊緣清晰率（86.00%）、后方回聲增強率（70.00%）、內部回聲不均勻率（26.00%）、大?。?.27±0.71）cm和對照組相比，差異無統計學意義（病灶邊緣清晰率相比，χ2=0.379，P=0.538;后方回聲增強率相比，χ2值=0.198，P=0.656;內部回聲不均勻率相比，χ2=0.508，P=0.476;大小相比，t=0.341，P=0.734）;實驗組其腫瘤有包膜的檢出率（0.00%）明顯低于對照組，腋窩淋巴結腫大的檢出率（56.00%）、形態不規則檢出率（34.00%）明顯高于對照組（腫瘤包膜檢出率相比，χ2=81.818，P=0.001;腋窩淋巴結腫大檢出率相比，χ2=38.889，P=0.001;病灶邊緣不規則形態檢出率相比，χ2=5.483，P=0.019）;實驗組1～3級血流的檢出率（94.00%）以及其RI值（0.75±0.04）明顯高于對照組（1～3級血流的檢出率相比，χ2=32.972，P=0.001;RI值相比，t=16.555，P=0.000）。 結論 根據彩色多普勒在乳腺髓樣癌與乳腺纖維瘤超聲圖像差異，可較好對其進行鑒別診斷。

[關鍵詞] 彩色多普勒超聲;乳腺髓樣癌;乳腺纖維瘤

[中圖分類號] R445? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）09（c）-0184-03

[Abstract] Objective To investigate the value of color Doppler ultrasound in the diagnosis of breast medullary carcinoma and breast fibroma. Methods A retrospective analysis of 50 patients with breast medullary carcinoma confirmed by pathology after operation in the Department of Ultrasound Imaging， Second Hospital of Sanming City， Sanming City， Fujian Province from May 2016 to May 2018， selected breast fibroma 50 patients were in the control group. The two-dimensional and color Doppler sonographic features of the lesion included the morphology， boundary， internal echo， axillary lymph node metastasis and color flow characteristics of the lesion， and the differences were compared. Results The diagnostic coincidence rate of the experimental group was 86.00%， and the diagnostic coincidence rate of the control group was 94.00%. The clear margin of the lesions in the experimental group （86.00%）， the enhancement rate of the posterior echo （70.00%）， the internal echo heterogeneity rate （26.00%）， and the size （2.27±0.71）cm. Compared with the control group， the difference was? statistically significant（the lesion edge margin ratio was compared with，χ2=0.379，P=0.538;the posterior echo enhancement rate was compared with，χ2=0.198， P=0.656;internal echo unevenness ratio，χ2=0.508， P=0.476;size comparison，t=0.341， P=0.734）; the detection rate of tumor envelope in the experimental group was significantly lower （0.00%）. In the control group， the detection rate of axillary lymphadenopathy （56.00%） and the irregular shape detection rate （34.00%） were significantly higher than those of the control group the tumor capsule detestion rate，χ2=81.818， P=0.001. The detection rate of axillary lymph node enlargement was compared with，χ2=38.889， P=0.001; compared with the detection rate of irregular morphology of lesion margin，χ2=5.483， P=0.019; experimental group 1～3 blood detection rate of the flow （94.00%） and its RI value （0.75±0.04） were significantly higher than those of the control group（and the detection rate of 1～3 blood flow was compared，χ2=32.972， P=0.001; RI value compared，t=16.555，P=0.000）. Conclusion According to the difference of color Doppler in the ultrasound images of breast medullary carcinoma and breast fibroma， it can be better diagnosed.