目的:探讨乳腺良恶性肿块二维超声图像和彩色多普勒血流状况,提高乳腺肿块的超声诊断符合率。方法:回顾性分析105例乳腺肿块的二维及彩色多普勒超声图像特点。结果:本组恶性肿块37例,超声诊断和疑诊恶性肿块32例,符合率为865%(32/37);良性肿块68例,超声诊断良性肿块58例,符合率为853%(58/68)。乳腺良恶性肿块在形态、 边界、 包膜、 内部回声、 后方回声、 沙粒样钙化、血流形态分布,血流动力学等方面具有明显差异。结论:二维及彩色多普勒超声对良恶性乳腺肿块有较高鉴别诊断价值。
【Abstract】Objective To estimate the value of the infra-red light scanning and the colored ultrasonic Doppler in diagnosis of breast masses. Methods Two hundred and seventy nine patients with breast mass were examined with the infrared light scanning and the colored ultrasonic Doppler in our hospital.Following the two examinations the masses were resected and pathologically examined as a control. Results The conformity of the infra-red light scanning with pathologic diagnosis was 94.0% in 182 hyperplasia masses, while that of the ultrasonic Doppler was 84.6%(P＜0.01). The conformity of the infra-red light scanning with pathology was 91.7% and that of the colored ultrasonic Doppler was 83.3%(Pgt;0.05). The colored ultrasonic Doppler was seemingly more effective than infrared light scanning in diagnosing 9 galactocele and 5 intraductal papilloma, but there is no significant difference(Pgt;0.05). The conformity of the two exams with pathology in 59 fibroadenoma was almost the same.Conclusion The infra-red light scanning is more effective than the colored ultrasonic Doppler in diagnosing the hyperplasia masses, there is no significant difference in diagnosing the breast cancer and the fibroadenoma between the two exams. Combined use of this two exams would increase the accurase of the breast masses.
目的 总结彩色多普勒超声（彩超）结合钼靶X线摄片标记定位对无临床体征乳腺肿块的定位诊断价值。 方法 2010年3月－2011年10月对48例彩超和钼靶X线检查发现可疑病灶而无任何临床体征的患者，在彩超引导下穿刺病灶金属导丝标记定位，并结合钼靶X线检查切除病灶，同时快速冰冻活检明确诊断。 结果 48倒中有11例确诊为乳腺癌（浸润性导管癌7例，导管内癌4例），37例为良性病变（纤维瘤5例，导管内乳头状瘤4例，乳腺腺病28例）。冰冻切片病理检查与术后石蜡病检结果一致。 结论 彩超引导下穿刺钢丝标记定位活检结合钼靶X线摄片，有效地解决了乳腺细小钙化和微小病灶活检术中精确定位和完整切除的难题，对无临床体征的微小乳腺肿块的诊断准确、可靠、实用。
【摘要】 目的 探讨隐蔽切口行乳腺肿块切除的经验。 方法 将1990年5月-2008年6月收治844例乳腺肿块患者随机设为观察组564例，采用乳晕缘切口，280例同期采用传统放射状切口的患者作为对照组，比较二者治疗效果。 结果 术后随访2～12个月，乳晕缘切口患者效果良好，切口瘢痕不显且保持了乳房的圆润外形；采用传统放射状切口的患者，乳房瘢痕宽大、明显。 结论 在熟悉乳房解剖及外科基本操作技术的基础上，开展乳晕缘切口行乳房肿块切除术是安全可行的，既达到了治疗目的，又符合美学要求，值得临床推广应用。【Abstract】Objective To explore the method of breast phymas via periaeoral incisions. Methods From May 1990 to June 2008, 844 patients with breast phyma were divided into the investigation group (564 patients) and the control group (280 cases). Incision around areola mammae was performed on the former group, the traditional radial incision was performed on the latter group，and then the results of the treatment were compared between the two groups. Results Follow-up visit ranged from two months to 1 year, all patients resulted in good effects, concealed scars, and remaining smooth shapes in the investigation group, and periareolar incisions was simpler and with less complication. Conclusion It is both safe and practicable to perform breast phyma excision via periareolar incision, on the basis of good understanding to breast anatomy and skillful operation.It can achieve the goal of treatment and meet the requirements of aesthetics as well, and hence is worthy of being recommended in clinical practice.
目的:探讨麦默通装置在乳腺微创外科中的应用。方法:44例共113个乳腺多发肿块均采用麦默通装置8G穿刺针在彩超引导下进行肿块切除术,术后送常规病理检查。结果:所有肿块均为完全切除,大小为0.4--5.5cm,56个为临床不可扪及的肿块,占49.6%,存在两种以上的病理改变9例,占20.5%,手术平均耗时12.5min,平均出血18.6mL。术后8例局部青紫,3例切口下血肿,均保守治疗后痊愈,无切口感染与瘢痕发生。结论:彩超引导下麦默通乳腺微创旋切术是一种早期诊治乳腺肿瘤安全、合理、有效、符合美学观点的方法,尤其适用于多发和无法触及的肿块。
目的 探讨超声引导麦默通（Mammotome）微创旋切系统对乳腺多发肿块进行微创切除的应用价值。方法 对56例乳腺多发肿块患者在超声引导下行麦默通微创旋切术的临床资料进行回顾性分析，评价麦默通微创旋切术在乳腺多发肿块切除中的应用价值。结果 256个乳腺肿块经术后病理学诊断均为良性，其中纤维腺瘤或乳腺腺病伴腺瘤形成224个，乳腺腺病16个，乳腺囊肿13个，导管内乳头状瘤3个。本组并发症主要为术中出血2例及术后血肿3例，发生率为8.9% （5/56）。56例患者均获临床和超声随访3～32个月，平均11个月，所有患者均无异常，乳房外观美容效果满意，未见复发及恶性病变发生。结论 麦默通微创旋切术切除乳腺多发病灶效果好，微创优势明显，操作简单、安全，值得推广。
【摘要】目的探讨超声导向下Mammotome活检及旋切系统切除乳腺肿块的并发症及其处理。方法在超声导向下，利用Mammotome系统对乳腺肿块进行活检和切除，对出现的并发症进行及时的处理。结果46例患者的75个乳腺肿块被切除，病理证实68个为纤维腺瘤，7个为纤维腺病。术中并发症包括出血、血肿和胸大肌损伤，经及时处理后恢复，术后并发症为瘢痕形成。结论Mammotome乳腺肿块切除术具有创伤小、并发症少的优点，是一种有效的、不影响乳房外观的微创手术，超声监控能够减少和发现并发症并进行正确的处理。
ObjectiveTo systematically review the clinical value of the contrast-enhanced ultrasonic in the diagnosis of breast tumors. MethodsWe electronically and comprehensively searched the databases including The Cochrane Library (Issue 2, 2013), PubMed, CNKI, WanFang Data, Chaoxing medalink, VIP, and CBM for clinical research reports of diagnosing breast cancer with Contrast-enhance ultrasonic (all from foundation to May 2013). Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies according to the QUADAS items. The Meta-DiSc software (version 1.4) was used to conduct pooling on sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Heterogeneity test was performed and the summary receiver operating characteristic (SROC) curve was drawn for area under the curve (AUC). ResultsA total of 19 studies involving 1 161 participants were included. The results of meta-analysis showed that, specificity, the pooled sensitivity, positive likelihood ratio, negative likelihood ratio and DOR were 0.79 (95%CI 0.75 to 0.82), 0.86 (95%CI 0.83 to 0.89), 3.92 (95%CI 2.77 to 6.56), 0.18 (95%CI 0.13 to 0.26), and 25.86 (95%CI 13.77 to 48.55), respectively. The AUC of the SROC curve was 0.917 0. ConclusionThe current evidence shows that contrast-enhanced ultrasonic has high sensitivity and specificity in the diagnosis of preoperative benign and malignant breast mass, which indicates that it could be used as a good method to diagnosing breast tumors.
Objective To explore the value of three-dimensional contrast-enhanced ultrasound angiography in the differential diagnosis of breast masses. Methods A total of 120 patients with breast masses who were treated in our hospital from July 2013 to February 2016 were selected as the research objects retrospectively, including 70 patients of benign tumor (benign group) and 50 patients of malignant tumor (malignant group) that confirmed by surgery and pathology. All patients were given conventional two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography during the diagnosis. Compared the imaging features of benign group and malignant group, and compared the diagnostic value of two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography for breast masses. Results Compared with benign group, the rates of irregular masses, unclear boundary, inhomogeneous echo, lateral shadowing, echo attenuation, and micro calcification in the malignant group were all higher (P<0.05). The three-dimensional contrast-enhanced ultrasound angiography scores in malignant group and benign group were significantly different with each other (P<0.05), the score of the malignant group was higher than that of benign group. The 2- and 3-score was common in benign group, but 4- and 5-score was common in malignant group. The diagnostic sensitivity of two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography for breast masses were 97.1% (68/70) and 98.6% (69/70) respectively, and the specificity were 80.0% (40/50) and 96.0% (48/50) respectively, the specificity of three-dimensional contrast-enhanced ultrasound angiography was significantly higher than that of two-dimensional ultrasound (P<0.05). Conclusion Two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography both have a certain diagnostic value in the differential diagnosis of breast masses, but the three dimensional contrast-enhanced ultrasound angiography can get more information through assessment of richness of the microvascular in tumor tissue, so as to improve the diagnostic specificity and is worthy of popularization and application.