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.
Toexploretheinfluenceoflocalmassiveexcisionbeforeradicalsurgeryonprognosisofpatientswithbreastcancer,wecomparedtheprognosisbetweenthegroupunderwentlocalresectionpriortoradicalsurgery(106cases)andthegorupwithdirectradicalresection(143cases).Theresultsshowedthatthelocalrecurrencerate,distancemetastasisrateandthesurvivalrateat3,5yearsofthegroupunderwentlocalexcisionpriortoradicalsurgerywere16.0%,26.4%,79.2%,71.7%respectivelyandofthegroupunderwentdirectradicalresectionwere4.9%,16.1%,89.5%,82.5%respectively,thedeferencewassignificant(Plt;0.01,0.05,0.05,0.05respectively).Theresultsindicatethatthelocalexcisionbeforeradicalsurgerycanaffecttheprognosisofpatientswithbreastcancer.
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。
目的 分析眼表面肿块的发病情况及组织病理学特点。 方法 对2004年1月-2008年12月收治并经病理学证实的326例眼表面肿块患者的年龄、性别、眼别、肿块发生部位、肿块性质及病理类型进行回顾性分析。 结果 326例眼表面肿块中，良性肿块264例（81.0%），恶性肿块62例（19.0%）。良性肿块中，前5位分别为色素痣67例（25.4）%，迷芽瘤63例（23.9）%，乳头状瘤39例（占14.8）%，结膜囊肿25例（9.5）%，炎性肉芽肿20例（7.6）%。恶性肿块中，前4位分别为鳞状细胞癌25例（40.3）%，淋巴瘤13例（21.0）%，恶性黑色素瘤12例（19.4）%，原位癌10例（16.1）%。 结论 眼球表面的肿块有共同的组织细胞起源，肿块的亚型表现出不同的组织结构、良恶性和好发部位；而同部位的良性、交界性和恶性病变的衍变发展，从某种程度上体现了一个疾病的不同发展阶段，三者间的鉴别和明确的病理诊断能为临床选择手术时机及手术方式提供依据。
【摘要】 目的 探讨多层螺旋CT血管造影（MSCTA）对腹部巨大肿块定位定性的诊断价值。 方法 收集2005年6月-2009年12月98例腹部巨大肿块，作MSCTA检查，观察供血动脉来源和肿块与血管关系。 结果 98例肿块发现有主要供血动脉76例，其中恶性肿块69例，血管受侵改变51例。 结论 由于MSCTA快捷、无创、经济、方便、空间分辨率高等优点，对腹部巨大肿块定位定性有较高诊断价值。【Abstract】 Objective To investigate the diagnostic value of multislice CT angiography (MSCTA) to abdominal huge mass from June 2005 to December 2009. The relation among blood vessel and supply origin and tumor was analyzed. Methods MSCTA was performed in 98 cases with abdomenial huge mass. Results The feeding artery of mass was discovered in 76 cases, in which malignant tumors were confirmed in 69 cases, the vessels were encroached on in 51 cases. Conclusion MSCTA may be of high value to diagnose abdominal huge mass because of noninvasiveness, convenience, and high resolution.
【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 探讨胰头部肿块型慢性胰腺炎的诊断要点与个体化术式的选择原则。方法 回顾性分析2000年4月至2011年9月期间我院收治的10例胰头部肿块型慢性胰腺炎患者的临床资料。结果 本组平均发病年龄47.3岁，平均病程69.1d，平均总胆红素99.4µmol/L，CA19-9 55～78U/ml。10例B超检查示肝内胆管及胆总管扩张，5例CT检查报告胰头部占位性病变伴主胰管不规则扩张或钙化灶，2例MRCP检查诊断胆总管下段占位。3例术中多点穿刺快速活检后行胆胰管引流术，7例术前误诊为胰头癌或壶腹癌均行胰十二指肠切除，术后出现并发症8例，死亡1例，9例平均随访44.2个月无复发和癌变。结论 把握发病年龄、病程、波动性黄疸等临床特征和CA19-9水平及CT、MRCP等影像检查要点是胰头部肿块型慢性胰腺炎与胰头癌鉴别诊断的关键，用个体化术式合理实施胰十二指肠切除、胆胰管内外引流术是胰头部肿块型慢性胰腺炎外科处理明智的选择。