彩色多普勒超声在乳腺导管内乳头状瘤诊断中的应用

Color Doppler ultrasound in the detection of intraductal papilloma

关键词:  超声  BI-RADS乳腺分级  乳腺导管内乳头状瘤

Key words:  ultrasound  BI-RADS-US-grading  intraductal papilloma

摘要:

［目的］评价高频彩色多普勒超声在乳腺导管内乳头状瘤诊断中的应用价值。［方法］回顾性分析64例经手术病理证实的乳腺导管内乳头状瘤患者的89个病灶，根据其声像图表现进行分型，并对发现的实性病灶按BI-RADS-US分级标准进行评价。［结果］64例中与手术病理相符者47例，准确率73.4%，按声像图表现可分为导管型及实质型。导管型诊断准确率22/25（88.0%）；实质型诊断准确率25/37（67.6%）。将实质型病灶按大小（≧2 cm及<2 cm）进行形态学特征比较，发现良、恶性病灶按BI-RADS-US分级标准的超声特征差异无显著性意义。［结论］二维及彩色多普勒超声检查可以对乳腺导管内乳头状瘤做出较明确的诊断和定位，但对于良、恶性的鉴别诊断仍有一定局限性。临床应用中要注意对实质性导管内乳头状瘤提高认识，为临床提供相关信息，提早治疗，减少发生恶变的可能性。

Abstract:

［Objective］To evaluate the application of high-frequency color Doppler ultrasound in the diagnosis of intraductal papilloma (IDP). ［Methods］Sixty-four IPD patients, pathologically proven by surgery with 89 lesions was analyzed retrospectively. The ultrasonography performance indicated their classifications. The solid focal was evaluated according to the BI-RADS-US standard. ［Results］There were 47 cases corresponding with pathological findings in the 64 patients. The accuracy was 73.4%. Catheter and solid types were classified. Catheter diagnostic accuracy was 22/25 (88.0%) and solid diagnostic accuracy was 25/37 (67.6%). Morphological tests showed in different sizes of lesions, there were no significant differences between benign and malignant lesions by BI-RADS-US grading standard. ［Conclusions］Two-dimensional ultrasound and Color Doppler flow imaging (CDFI) can make a definite diagnosis and positioning for IDP. But there are still some limitations to differentiate the benign and malignant. Attention must be paid to the clinical application of substantive intraductal papilloma. The solid focal should be understood better and more relevant clinic information should be collected. If confirmed, the focal should be treated as early as possible to reduce the possibility of malignant transferring.