摘要
目的探讨乳腺黏液癌的超声声像特征及其与不同病理组织类型之间的关系，提高乳腺黏液癌的超声诊断率。方法回顾性分析手术后病理证实的22例23个乳腺黏液癌病灶的声像特征，根据美国放射学会的超声BI—RADS要求分析肿块的声像特征等并于术前进行BI—RADS分类诊断；根据病理组织类型进行超声声像图分析。结果病理组织学分类包括15个单纯型和8个混合型，前者包括7个富细胞型，8个少细胞型。所有患者均存在无假包膜的实性肿块，86．7％（13／15）的单纯型病灶境界清楚，内部回声等于或略低于皮下脂肪回声；93．3％（14／15）的单纯型病灶后方回声增强。所有单纯型肿块方向平行于皮肤。75．0％（6／8）混合型肿块边界较模糊并细小毛刺边缘，内部回声更低（Pd0．01），混合型较单纯型更具恶性特征。总体65．2％（15／23）的病例疑恶性，提示BI-RADS4级或5级，其中单纯型9例（60．0％），混合型6例（75．0％）。结论乳腺黏液癌尤其单纯型不具备典型乳腺癌恶性肿块的声像特征，单纯型常表现良性肿块声像改变，但均无假包膜这一良性肿块声像特征，混合型肿块较单纯型更具有恶性声像特征，建议超声以BI-RADS4级来提示乳腺黏液癌以避免延误诊断。
Objective To investigate ultrasonographic （US） features of mucinous breast carcinoma with pathological correlation and to improve the early diagnosis for the mucinous breast carcinoma. Methods Twenty-two patients with 23 focuses mucinous carcinoma of the breast confirmed by pathology were included in this study, retrospectively evaluate sonograpbic features according to the American College of Radiology（ACR） Breast Imaging Reporting and Data System（BI-RADS） Lexicon, all cases were classified by BI-RADS before operation. Histological type of mucinous breast carcinoma included mixed and pure two forms,the latter was classified into cellular variants and hypocellular variants. The correlation between the ultrasonographic findings of mucinous carcinoma and histologic features in different types were analysed. Results On US examination,all 22 cases presented as solid mass. In pure form, they showed well-defined margins with no pseudocapsule and isoechogenic or hypoechoic internal echo pattern relative to that of subcutaneous fat in 86.7% （13/15） focuses which histological type were pure type. 93.3% （14/15） of pure type focuses had posterior enhancement. All pure type focuses demonstrated that the orientation of the mass is parallel to the skin line. 75.0% （6/8） of mixed type focuses and 13.3% （2/15） of pure type focuses, however, demonstrated ill-defined and or spiculated margins with more hypoechogenic structure （P% 0.01）. Mixed type focuses have more aggressive malignant features. 65.2% （15/23） of cases being classified as BI-RADS 4 or 5 were suspected as malignancy, which included 6 mixed type focuses and 9 pure type respectively accounting {or 75.0% （6/8） and 60.0 % （6/15） of each type focuses. Conclusions Mueinous breast carcinoma especial pure type did not have the typical malignant breast masses sonographic features,which showed some benign masses sonographic features except no pseudocapsule benign feature. Mixed type mucinous carcinomas tumors have more aggressive margin imaging characteristics. It is suggested that mucinous breast carcinoma should be classified category 4 by BI-RADS to avoid diagnosisdelay.
出处
《中华超声影像学杂志》
CSCD
北大核心
2012年第12期1056-1059,共4页
Chinese Journal of Ultrasonography
基金
深圳市医学科研基金项目（201102093）
关键词
超声检查
乳腺肿瘤
腺癌
黏液
Ultrasonography Breast neoplasms
Adenocarcinoma, mucinous
