38例乳腺癌的彩色多普勒超声诊断价值分析

陈灵丽

[摘要] 目的 探讨彩色多普勒超声诊断乳腺癌的临床价值。 方法 回顾性总结分析2009年1月～2012年1月笔者所在医院收治的38例乳腺癌患者超声声像图特征。 结果 38例乳腺癌患者形态不规则，呈“蟹足样”改变28例，边缘不光滑，呈毛刺样改变，肿块多为低回声，可见细沙粒样钙化灶（共16例）。后方回声衰减10例，CDFI显示纵横比≥1共8例。血流分级：0级3例，I级9例，Ⅱ级10例，Ⅲ级14例，检出率为94.7％，2例未见血流信号。腋窝淋巴结肿大8例（21.1％）。 结论 彩色多普勒超声检查能清晰显示乳腺癌的大小、形态、内部结构及血流分布情况，因此，彩色多普勒超声可以作为诊断乳腺癌的常用手段之一，值得推广和应用。

[关键词] 乳腺癌；彩色多普勒超声；诊断价值

[中图分类号] R737.9???[文献标识码] B???[文章编号] 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

近年来，乳腺癌在我国已经成为女性常见的恶性肿瘤之一，其发病率和死亡率均位于女性肿瘤的前3位[1]。寻找一种操作方法简便、可重复性强、效果可靠、价格相对较低且诊断准确率较高的方法，对于乳腺癌的早期诊断具有重要的临床价值[2]。彩色多普勒超声对乳腺癌的诊断体现了较好的优势，彩色多普勒超声检查对乳腺癌的诊断起着越来越重要的作用[3]。本研究回顾性分析了38例乳腺癌患者的彩色多普勒超声的超声声像图特征，旨在为乳腺癌的诊断与鉴别诊断提供有价值的依据，现报道如下。

1?资料与方法

1.1?一般资料

选择2009年1月～2012年1月于笔者所在医院手术且术后经病理检查确诊的38例乳腺癌患者，年龄28～72岁，平均（46.5±3.1）岁。均为单侧，其中左侧20例，右侧18例。肿块大小1.7 cm×2.4 cm～7.2 cm×8.1 cm。

1.2?检查方法

使用Philips HD Evensior彩色多普勒超声诊断仪，探头频率3～12 MHz。患者取仰卧位，或根据需要取侧卧位，双臂上举稍外展，充分暴露乳房和腋窝，以乳头为中心做放射状扫查，观察肿块的大小、位置、形态边界、有无钙化。并应用彩色多普勒血流显像（CDFI）观察肿块内部及周边血流，应用脉冲多普勒血流显像（PW）测血流速度及阻力指数。血流检测包括肿瘤彩色血流信号分级及频谱血流参数，肿块血流分级采用Adler标准[4]：0级：病灶内无血流；Ⅰ级：少量血流病灶内1～2个点状或细棒状血管；Ⅱ级：中量血流，可见34个点状血管或1条重要血管，其长度可接近或超过病灶半径；Ⅲ级：丰富血流，见5个以上点状血管或2条较长血管或弥漫性网状血管，记录病灶彩色多普血流阻力指数。同时检测腋下有无淋巴结肿大，分析淋巴结肿大的形态及结构特征。