乳腺黏液腺癌的超声表现及误诊原因分析

Ultrasonic manifestation of mucinous breast adenocarcinoma

关键词:  乳腺  黏液腺癌  超声声像图

Key words:  breast  mucinous carcinoma  ultrasoundgram

摘要:

目的 探讨乳腺黏液腺癌(mucinous breast carcinoma, MBC)不同病理类型的超声图像特点,并分析其误诊原因。方法 回顾性分析79例经超声诊断且手术后病理确诊的MBC患者的超声及病理资料,超声诊断标准参照乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)。结果 79例MBC共79个病灶,单纯型31例,混合型48例；术前超声诊断为恶性病变36例,其中单纯型MBC超声诊断恶性13例、混合型MBC超声诊断恶性23例,诊断敏感性分别为42%、48%,两种病理类型的MBC超声诊断敏感性无统计学意义(P=0.378)。单纯型MBC与混合型MBC的形态、边界、病灶内血流信号、直径、边缘毛糙、内部钙化灶、后方回声增强等声像图特点差异无统计学意义(P>0.05),腋窝有无肿大淋巴结差异有统计学意义(P<0.05)。结论 MBC超声特征不明显,误诊率较高,应结合病理诊断结果分析图像特点,以提高术前超声诊断。

Abstract:

Objective To examine ultrasonic manifestations of different pathological types of breast mucous adenocarcinoma. Methods The ultrasonic manifestations and pathological diagnosis of 79 cases of breast mucous adenocarcinoma were retrospectively analyzed. The ultrasound diagnosis was based on the BI-RADS standard. Results The sensitivity of ultrasonic diagnosis for simplex the mucous adenocarcinoma and hybrid breast mucous adenocarcinoma was 42% and 48%, respectively(P=0.378). The ultrasonic analysis included the shape, border, blood flow, tumor diameter, feature of the lesion edge, internal calcification, posterior echo enhancement, axillary lymph nodes. Axillary lymph node swelling was statistically significant in the differential diagnosis of breast mucinous carcinoma(P<0.05), other ultrasonographic characteristics had no statistical differences(P>0.05). Conclusion The missed diagnostic rate of breast mucous adenocarcinoma is high, ultrasonographic examination combined with the pathological diagnosis can improve the diagnosis.