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目的探讨高频彩色多普勒超声对乳腺髓样癌的诊断价值。方法 56例乳腺髓样癌患者,均为女性,年龄25～87岁,平均年龄50.92岁;其中典型髓样癌35例,非典型髓样癌21例。患者手术前行乳腺超声检查,先用灰阶超声观察肿块的部位、大小、形态、边界、内部回声、有无钙化、后方回声增强或衰减,再启用彩色多普勒血流显像(CDFI)检查肿块的血流信号,频谱多普勒分析肿块血流阻力指数(RI),最后检查腋窝淋巴结有无肿大。结果乳腺髓样癌发生于左侧乳腺者占57.14%,高于右侧乳腺的42.86%,但差异无统计学意义(P>0.05)。典型髓样癌最大径平均值为2.39cm,略小于非典型髓样癌的2.52cm(P>0.05)。与非典型髓样癌比较,典型髓样癌形态较规则、边界较清楚、内部回声较均匀,多伴后方回声增强,钙化较少见。乳腺髓样癌血液供应多较丰富,该组32例典型髓样癌、18例非典型髓样癌进行了CDFI检查,血流Ⅱ/Ⅲ级者分别占65.63%、61.11%(P>0.05),其中20例进行了多普勒频谱分析,RI>0.70。结论典型髓样癌与非典型髓样癌在肿块的边界、回声均匀与否,有无钙化及后方回声增强等超声表现明显不同,术前高频彩色多普勒超声检查具有重要诊断价值。
Objective To investigate the diagnostic value of high frequency color Doppler ultrasound in medullary myeloid carcinoma. Methods 56 patients with medullary carcinoma of the breast were female, aged 25-87 years, with an average age of 50.92 years. Among them, 35 were typical medullary carcinoma and 21 atypical medullary carcinoma. The patients underwent ultrasound examination of the breast before surgery, and the gray scale ultrasound was used to observe the location, size, shape, boundary, internal echo, calcification, enhancement or attenuation of the posterior echogenicity, and then enable color Doppler flow imaging (CDFI) Check the tumor blood flow signal, the spectrum Doppler analysis of mass flow resistance index (RI), and finally check the axillary lymph nodes with or without swelling. Results Medullary medullary carcinoma in the left breast accounted for 57.14%, higher than the right breast 42.86%, but the difference was not statistically significant (P> 0.05). The average maximum diameter of typical medullary carcinoma was 2.39cm, slightly less than 2.52cm of atypical medullary carcinoma (P> 0.05). Compared with atypical medullary carcinoma, the typical morphology of medullary carcinoma is more regular, the boundary is clearer, the internal echo is more uniform, and the echo of the posterior is enhanced. The calcification is rare. CDFI was performed in 32 medullary carcinomas and 18 atypical medullary carcinomas in this group. The blood flow grade Ⅱ / Ⅲ accounted for 65.63% and 61.11% respectively (P> 0.05) , Of which 20 were Doppler spectral analysis, RI> 0.70. Conclusion The typical manifestations of myeloid carcinoma and atypical myeloid carcinoma are obviously different at the boundary of the mass, the echo uniformity, the presence or absence of calcification and the enhancement of posterior echo. Preoperative high-frequency color Doppler ultrasonography has important diagnostic value.