【摘要】 目的 探讨多功能彩色多普勒超声对乳腺肿瘤检查的价值，并与手术病理结果做对照分析。方法 本文对132例乳腺肿瘤使用多功能彩色超声5～10MHz高变频探头进行检查，二维超声分析良恶性肿瘤的外形、内部结构、后壁组织回声及肿瘤与周围组织的关系等。用彩色多普勒(CDFI)观察分析良恶性肿瘤血流信号，血管在肿瘤内部及周边的分布走行、丰富程度。用多普勒频谱测定血流最高流速(Vmax)和阻力指数(RI)参数，并进行统计学分析。结果 132例乳腺肿瘤超声诊断80例为良性肿瘤，52例为恶性肿瘤。与病理结果对照，乳腺良性肿瘤1例不符合， 为巨纤维腺瘤核分离属潜在性癌变；超声诊断符合率达98.8%。乳腺恶性肿瘤超声诊断3例不符合，其中2例为腺癌，部分上皮呈乳头状增生，另1例为软组织瘤伴感染；超声诊断符合率达94.2%。浸润性导管癌在乳腺恶性肿瘤中占多数，共33例，硬癌5例，髓样癌11例。乳腺良性肿瘤以纤维腺瘤为多见，共54例，炎性肿块7例，囊性肿块18例。结论 二维声像图在诊断乳腺良恶性肿瘤方面有一定的特征性。结合CDFI血流信号参数，可提供较可靠的诊断依据。乳腺肿瘤超声显像的透声及形态因病理组织特性而不同。以细胞成分为主的显像透声好，以纤维组织为主的则透声差。肿瘤的形状与肿瘤生长方式有直接关系。女性乳腺肿瘤的发病率甚高，超声检查乳腺肿瘤是目前临床上不可缺少的诊断方法。

    【关键词】 乳腺肿块；声像图；彩色多普勒超声

    Assessment of mammary nodular lesions using multi-functional color-coded Doppler ultrasonography

    YAO Ya-juan.

    The Fifth Hospital of Wuxi,Wuxi 214002,China

    【Abstract】 Objective To evaluate characteristics of mammary nodular lesions by multifunctional color-coded Doppler ultrasonography,comparing with the surgical and pathological specimen findings.Methods Using alter-frequency MCDU detector range from 5 to 10 MHz to examine 132 patients with mammary nodular lesions.First,using two dimension ultrasonographic display to document the mass outline,its inner structure,post-nodular tissue echo pattern and the relationship between nodular lesion and its surrounding tissue.Second,calculating CDFI index to show the DUS flow pattern in the nodular lesion,its vascular distribution inner and outside the nodular lesion.Third,using Doppler ultrasound spectrum to measure the flow speed(Vmax)and its resistance(RI).After obtain the data above,we employ the Chi-square test method to evaluate statistically.Results There are 52 cases of malignant mass and 80 cases of benign mass after the surgical and pathological specimen examination in above 132 patients.There is only one case detected benign which is actually borderline malignancy.So the overall positive rate 98.8%.There are three cases detected malignant which are actually benign lesions.(One of them having surrounding tissue inflammation,and the other two are papillary epithelial hyperplasia which is a kind of mammary benign lesion).So the overall negative rate 94.2%.In the present-positive group,there are 33 cases of invasive intraductal carcinoma,5 cases of stroma carcinoma and 11 cases of medullary carcinoma;while in the present-negative group,there are 54 cases of fibroadenoma,7 cases of inflammation and 18 cases of fibrocystic disease.Conclusion Two-dimensional displays of the MCDU have major characteristic features to differentially determine the nodular lesions in mammary gland.If combined with the CDFI index,the manifestation will be much more significant.Because the MCDU pattern show the different tissue composition of the nodular lesions,which the fibril tissue is ultrasound reflective while the cellular tissue is almost always ultrasound absorptive which is also related with the tumor growth pattern,MCDU is an indispensable diagnostic assist for the mammary nodular lesions which prevailing all-aged female. ......