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目的探讨常规彩超结合超声弹性成像对乳腺肿块的误诊原因。方法回顾性分析超声诊断的25个乳腺肿块中假阴性14个,假阳性11个的二维图像和弹性成像的误诊原因。结果超声弹性成像对于直径>3 cm且伴液化、出血、坏死的肿块良恶性鉴别能力有限,恶性肿块内的液化坏死可使组织变软,而良性病变发生一些继发改变(如出血、纤维化、钙化等)时,其硬度可增加。结论拓宽诊断思路,正确认识弹性成像原理,对于较复杂的病灶应跟踪随访或穿刺活检,不可草率诊断。
Objective To investigate the causes of misdiagnosis of breast masses by conventional color Doppler ultrasound and elastography. Methods We retrospectively analyzed 14 cases of false-negative and false-positive 2-dimensional images and 25 cases of misdiagnosis of elastography in 25 breast masses diagnosed by ultrasound. Results Ultrasound elastography has limited ability to differentiate benign from malignant masses with liquefaction, hemorrhage and necrosis of> 3 cm in diameter. Liquefaction and necrosis within the malignant tumor may soften the tissue and some secondary changes of benign lesions (such as hemorrhage and fibrosis , Calcification, etc.), its hardness can be increased. Conclusion Broaden the diagnostic ideas and correctly understand the principle of elastic imaging, follow-up or biopsy should be followed for more complex lesions, not to be staged diagnosis.