目的通过乳腺导管内癌病变在常规超声及超声弹性图中各种表现,探讨二者对导管内癌的诊断价值。方法经术后病理证实的17例乳腺导管内癌病灶,术前经常规超声及实时超声弹性成像检查,观察病变的灰阶、彩色多普勒血流显像及弹性图特征。结果17例患者中,1例患者在超声及钼靶X线摄影均为假阴性,余16例灰阶声像图表现为肿块型11例,局部乳腺结构紊乱型;无血流者2例,中等血流8例,血流丰富6例,病灶范围较大者(≥2cm)血流相对丰富(P=0.011);16例病变常规超声诊断均诊断为恶性(7例为BI-RADS4级,9例为BI-RADS5级)。16例病灶超声弹性成像表现为3级1例,4~5级15例。结论DCIS超声声像图主要表现为肿块或局部乳腺结构紊乱。弹性成像可识别DCIS和正常组织间的弹性差异,可能对于准确识别DCIS病变、鉴别诊断方面有潜在的用途。
Objective To determine the features of non-invasive breast cancers on conventional US and elastograms thus further explore their diagnostic values in the non-invasive breast cancers. Methods Pathologically proved 17 non-invasive breast cancers with preoperative US and real-time elastogram were selected from 308 consecutive patients. They underwent biopsy with either palpable, nipple discharge or ultrasonically visible breast lesions. The features on gray scale US, color Doppler flow imaging (CDFI) and elastogram were documented. Results Of 17 cancers, one lesion was negative either the US or mammography. In the remaining 16 lesions detected on US, 11 of them were masses and 5 of them were ductal distortion. Six lesions featured with micro-calcification on US. CDFI demonstrated absence of color flow in 2 lesions, median flow in 8 and abundant flow in 6. The larger cancers showed statistically significantly abundant flow than those of small ones (P 〈0. 005). US correctly categorized these 16 lesions to BI-RADS 4 or 5. On elastogram, 15 were scored as 4 and 5 and 1 was scored as 3. A specific mosaic pattern was found in 7 of DCIS, which was some small round hard areas blended with normal hardness tissues. Conclusion DCIS featured as mass and ductal distortion with or without micro-calcification on US. It was more likely for elastography to detect the differences on tissue hardness between the non-invasive breast cancers and could be helpful to detect and characterize non-invasive breast cancers.