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目的 :探讨高频超声对小乳腺癌的诊断价值。方法 :对经手术病理证实的 19例小乳腺癌 (直径 <2 cm)的二维声像图、彩超多普勒显像 (CDFI)、能量图显像 (PDI)的特点进行了回顾分析。结果 :19例小乳腺癌均为单发 ,发生在乳腺外上象限 14例 ,内上象限 3例 ,外下象限 2例。同侧腋窝淋巴结肿大 9例。病理类型 :单纯癌 9例 ,髓样癌 6例 ,浸润性导管癌 3例 ,小叶癌 1例。 19例小乳腺癌二维声像图均表现为低回声结节 ,多数边界清楚 ,边缘不整齐 ,表面不光滑 ,少数有角样伸出。肿块纵横径比 >1,有 6例肿块内有点状或簇状砂粒状高回声。 CDFI和 PDI均见血流信号 ,并显示血管走行扭曲。阻力指数 >0 .70。本组 19例小乳腺癌有 9例同侧腋窝淋巴结肿大 ,淋巴结纵横径之比 >1,PDI显示淋巴门结构紊乱。结论 :下列方法有助于小乳腺癌的诊断 :(1)逐一多切面扫查 ,尤其乳腺边缘部位以免漏诊 ;(2 )二维声像图仍是发现小乳腺癌的主要方法。由于恶性肿瘤的病理生理学基础 ,CDFI和 PDI有助于小乳腺癌的诊断与鉴别诊断 ;(3)发现同侧腋窝淋巴结肿大并有形态和 PDI血流改变是帮助确定诊断可靠佐证。高频超声、CDFI和 PDI联合应用 ,相互补充 ,综合判断 ,可以大大提高小乳腺癌诊断水平
Objective: To investigate the diagnostic value of high frequency ultrasound in small breast cancer. Methods: Nineteen cases of small breast cancer (diameter <2 cm) confirmed by surgery and pathology were retrospectively analyzed by two-dimensional sonography, color doppler imaging (CDFI) and energy imaging (PDI). Results: All the 19 cases of small breast cancer were solitary and occurred in 14 cases of the upper outer quadrant of the breast, 3 cases of the upper quadrant and 2 cases of the outer quadrant. Ipsilateral axillary lymph nodes in 9 cases. Pathological types: simple carcinoma in 9 cases, medullary carcinoma in 6 cases, invasive ductal carcinoma in 3 cases, lobular carcinoma in 1 case. Nineteen cases of small breast cancer two-dimensional sonography showed hypoechoic nodules, most of the border is clear, irregular edges, the surface is not smooth, a few horns protruding. Mass ratio of lumps> 1, there are 6 cases of tumor-like or clustered sand-shaped hyperechoic. Both CDFI and PDI showed signs of blood flow and showed distorted blood vessels. Resistance index> 0.70. The group of 19 cases of small breast cancer in 9 cases of ipsilateral axillary lymph nodes, lymph node size ratio of> 1, PDI showed lymphoid structure disorders. Conclusions: The following methods are useful for the diagnosis of small breast cancer: (1) one by one multi-slice scan, especially in breast margin to avoid misdiagnosis; (2) two-dimensional sonography is still the main method to detect small breast cancer. Because of the pathophysiology of malignant tumors, CDFI and PDI contribute to the diagnosis and differential diagnosis of small breast cancer. (3) It is found that the ipsilateral axillary lymph node enlargement and the change of shape and PDI blood flow are helpful to confirm the diagnosis. High-frequency ultrasound, CDFI and PDI joint application, complement each other, comprehensive judgment, can greatly improve the diagnosis of small breast cancer