实用医学杂志 ›› 2021, Vol. 37 ›› Issue (24): 3179-3183.doi: 10.3969/j.issn.1006⁃5725.2021.24.016

• 临床研究 • 上一篇    下一篇

纵横比大于1乳腺肿块的X线再评估及临床、超声特征分析

韩文1 李卫民2 吴晓明1 王亮亮3 凌莉1   

  1. 苏州高新区人民医院1 超声科,3 放射科(江苏苏州 215163);2 江南大学附属医院超声科(江苏无锡 214000)


  • 出版日期:2021-12-25 发布日期:2021-12-25
  • 通讯作者: 吴晓明 E⁃mail:ming_1968@sina.com
  • 基金资助:
    苏州高新区医疗卫生科技计划项目(编 号 :SGY2021B01)。

X⁃ray reevaluation and clinical and ultrasonic characteristics of breast lesions with depth⁃width ratio > 1 in ultrasound

 HAN Wen*,LI Weimin,WU Xiaoming,WANG Liangliang,LING Li.   

  1. Department of Ultrasound People′s Hospital of Suzhou National New Hi⁃tech Industrial Zone,Suzhou 215163,China

  • Online:2021-12-25 Published:2021-12-25
  • Contact: WU Xiaoming E⁃mail:ming_1968@sina.com

摘要:

目的 分析纵横比(depth⁃width,D/W)大于 1 乳腺肿块的 X 线再评估价值,并分析具有 D/ W > 1 超声特征乳腺良恶性肿块的临床和超声特征。方法 选取具有 D/W > 1 超声特征的乳腺肿块 317 例,应用 X 线检查进行再评估,依据病灶的 X 线表现进行 BI⁃RADS 分类,按临床处理原则的不同,将 BI⁃ RADS 1 ~ 3 类乳腺肿块评估为良性,将具有可疑特征的 BI⁃RADS 4 ~ 5 类乳腺肿块评估为恶性,以手术 病理作为金标准,计算 X 线再评估后的诊断准确率,并分析具有 D/W > 1 超声特征的乳腺良恶性肿块的临 床及超声特征。结果 317 例具有 D/W > 1 超声特征的乳腺肿块中,恶性 221 例,良性病灶 96 例,经 X 线再评估后,诊断的准确率明显提高,与超声比较,差异有统计学意义(P < 0.05)。临床资料中,恶性肿块患者 的年龄以及肿块的大小均大于良性肿块患者,差异有统计学意义(P < 0.05)。同时,在排除了 D/W > 1 超声特征后,良恶性肿块在形态、边缘、内部回声、后方回声、微钙化、血流、腋窝肿大淋巴结等方面差异均 具有统计学意义(P < 0.05)。结论 超声提示 D/W > 1 的乳腺肿块中仍存在部分良性肿块,这类肿块体积小、合并的其他可疑超声特征少等特点,经 X 线再评估后,可大大提高诊断的准确率,有效减少穿刺或手 术等有创性检查的发生。

关键词:

乳腺癌, 超声, 纵横比大于1, X 线检查

Abstract:

Objective To explore the value of X⁃ray reevaluation of breast masses with depth⁃width ratio > 1(D/W > 1)and further analyze the clinical and ultrasound features of benign and malignant breast masses with D/W > 1. Methods A total of 317 breast lesions with D/W>1 by ultrasound were included in the study. These lesions were reevaluated by X ⁃ ray and classified by BI ⁃RADS further. According to different principles of clinical treatment,the lesions with BI⁃RADS 1⁃3 categories were evaluated as benign,and the lesions with BI⁃RADS 4⁃5 categories were evaluated as malignant. The diagnostic accuracy of X⁃ray reevaluation was calculated according to the gold standard of pathological results. The clinical and ultrasonic features of the benign and malignant breast masses were analyzed as well. Results Of the 317 cases,221 were diagnosed as malignant and 96 as benign. The diagnostic accuracy after X⁃ray reevaluation was more significantly improved than that only with ultrasound(P < 0.05). In the clinical data,the age of patients with malignant tumors and the size of tumor in them were significantly larger than that with benign tumors(P < 0.05). Meanwhile,when the ultrasonic features of D/W > 1 were excluded,there were significant differences between the benign and malignant tumors in terms of shape,edge,internal echo,posterior echo,microcalcification,blood flow,axillary lymph node enlargement(P < 0.05). Conclusion Some benign lesions with D/W > 1 diagnosed as malignant initially by ultrasound are characterized by small volume and few other suspi⁃ cious ultrasound features. Combined with X⁃ray examination for reevaluation,the diagnostic accuracy can be greatly improved,and the incidence of invasive examinations such as puncture or operation can be reduced effectively.

Key words:

 , breast lesions, ultrasound, depth?width ratio >, 1, X?ray