摘要
目的探讨乳腺叶状肿瘤(PTB)的X线和超声影像表现特征,提高对本病的术前诊断水平。方法搜集经手术病理证实的23例PTB患者资料,回顾分析其影像学表现和临床及病理特点。23例术前均行X线摄片及超声检查,其中有3例术前行核芯针穿刺活检。结果 23例PTB术后病理诊断:良性6例,交界性4例,恶性13例;X线表现为直径1.70～13.5 cm单侧孤立肿块,呈类圆形5例,有分叶18例;高密度16例;边界清晰14例,7例伴有"晕征";2例伴有周围腺体结构扭曲,3例可见"彗尾征",4例伴有少量粗大钙化,5例伴有血管增粗;超声表现均为低回声团块,21例回声不均,5例有囊变坏死;6例后方回声增强;17例包膜完整;彩色多普勒血流显像显示13例血流信号丰富。本组均未见腋下淋巴转移。3例术前行核芯针穿刺病理诊断与术后病理诊断相符,交界性1例,恶性2例。结论 PTB影像表现有一定的特征,但缺乏特异性征象,多种影像检查方法联合应用,综合分析可提高术前诊断。对可能为PTB的病例行核芯针穿刺活检,结合免疫组织化学检查,可作为术前辅助诊断相对肯定的一种方法也可以用于肿瘤分级。
Objective To analyze the X ray and ultrasound performance of breast phyllodes tumor （PTB）, and to im prove the diagnosis accuracy. Methods The imaging and pathology data of 23 cases with breast phyllodes tumor （PTB） were retrospectively analyzed. 3 patients underwent stereotactie core needle biopsy （SCNB）, and all the patients underwent Xray and ultrasound examination. Results Among the 23 cases of PTB ,6 lesions were benign,4 were malignant and 13 were borderline tumors. X ray findings included unilateral isolated tumors with 1.70 em 13.50 cm in diameter. There were 18 cases showed lobulated mass, and others showed round mass. 16 of 23 masses were high density; 14 tumors had well defined margin, and 50% of which were accompanied by ＂Halo sign＂. Besides, there were some accompanying signs, including distortion of perifoeal structures （ n = 2 ） , comet tail sign （ n = 3 ） , a little coarse calcification （ n = 4 ）, Vascular thickening（ n = 5 ）. On ultrasound imaging, the main feature was Hypoechoic mass, 21 cases showed hypoechoic, and 6 cases had posterior echo enhancement; Cysticnecrosis areas were observed in 5 cases, and posterior acoustic enhancement was present in 11 cases, 17 cases had complete capsule. Color Doppler flow imaging （CDFI） showed rich blood flow signals in 13 cases. The whole group had no axillary lymph node metastasis. The Pathological diagnosis of stereotactic core needle biopsy （ n = 3 ） and Surgical were consistent, Including two cases of malignant, and one borderline tumors. Conclusion Imaging findings of PTB are some characteristics. Application of a variety of imaging, comprehensive analysis, which are key factors to improve the preoperative diagnosis. For preoperative diagnosis of SuspectedPTB cases, combining core nee dle biopsy with immunohistochemieal methods can be considered as a relatively accurate method. In addition, which can be applied to assess the tumor grade.
出处
《临床放射学杂志》
CSCD
北大核心
2013年第8期1096-1100,共5页
Journal of Clinical Radiology
基金
陕西省卫生厅科研基金资助项目子题目(编号:2010 D11)
