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[目的]探讨高频彩色多普勒超声对乳腺肿块的鉴别诊断价值。[方法]研究总结72例乳腺肿块高频二维超声声像图形态特征、彩色多普勒血流频谱特点、超声诊断及腋窝超声扫查结果,并与手术病理结果进行对照分析。[结果]术后病理证实超声诊断为乳腺肿块72例患者中,69例为乳腺癌,2例为乳腺纤维腺病,1例为叶状肿瘤;超声诊断为乳腺纤维腺瘤2例均确诊为乳腺导管癌;超声诊断为瘤样增生的1例确诊为原位癌。术后病理确诊为乳腺癌的69例中,67例(93.1%)边界不清,形态欠规则或不规则,部分(47例)边缘呈蟹足样或锯齿状改变,64例(88.9%)内部回声不均匀,45例(62.5%)内部有钙化点,51例(70.8%)有强回声边带。彩色多普勒频谱特征表现肿瘤内血流信号多数是Ⅱ级～Ⅲ级,PSV平均22.7±10.5cm/s,RI≥0.7的肿瘤占87.5%。结合彩色多普勒的超声诊断正确率为93.1%。腋下淋巴结转移31例,诊断正确率93.7%。[结论]高频彩色多普勒超声对乳腺肿块性质的诊断符合率高;区域淋巴结扫查有助于对乳腺癌的进一步确诊及术前临床分期。
[Objective] To investigate the value of high-frequency color Doppler ultrasound in the differential diagnosis of breast lumps. [Method] The morphological characteristics, color Doppler flow characteristics, ultrasonic diagnosis and axillary ultrasonography of 72 cases of breast lumps were summarized and compared with the results of surgery and pathology. [Results] The postoperative pathological diagnosis of breast tumor in 72 patients diagnosed by ultrasound in 69 cases of breast cancer, 2 cases of breast fibroadenosis, 1 case of leaf tumor; ultrasound diagnosis of breast fibroadenoma in 2 cases were diagnosed as Breast ductal carcinoma; Ultrasound diagnosis of tumor-like hyperplasia in 1 case diagnosed with carcinoma in situ. Among the 69 cases diagnosed as breast cancer by pathology, 67 cases (93.1%) had unclear boundary and irregular or irregular shape. Some (47 cases) showed crab-like or jagged edges, and 64 cases (88.9% Internal echo uneven, 45 cases (62.5%) calcification within the point, 51 cases (70.8%) with strong echo sidebands. Color Doppler spectral characteristics of the tumor blood flow signals are mostly grade Ⅱ ~ Ⅲ, PSV average 22.7 ± 10.5cm / s, RI ≥ 0.7 tumors accounted for 87.5%. Combined with color Doppler ultrasound diagnostic accuracy was 93.1%. Axillary lymph node metastasis in 31 cases, the correct diagnosis rate of 93.7%. [Conclusion] The coincidence rate of high frequency color Doppler ultrasound in the diagnosis of breast masses is high. The regional lymph node scan is helpful for the further diagnosis and preoperative clinical staging of breast cancer.