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目的:通过对乳腺叶状肿瘤(PTB)的超声声像图特征及其病理基础的分析来提高对本病的认识。方法:回顾性分析本院的乳腺叶状肿瘤患者经手术病理证实30例作二维及彩色多普勒血流显像(CDFI)超声的表现与病理结果对照。结果:30例PTE患者中良性18例、交界性7例、恶性5例。二维超声图像PTB表现为明显分叶或浅分叶的肿块20例、呈椭圆形或类圆形10例,具有体积较大、内部回声不均匀而后方回声增强、良性者有包膜边界清而恶性者边界模糊不清等特征。CDFI表现出良性病例血流0～Ⅰ级,恶性病例血流Ⅱ～Ⅲ级、并且阻力指数偏高(RI≥0.75)。PTB病理表现以大量间质异形细胞成分为主并膨胀性生长、变性坏死侵犯包膜等病变,此病理基础与上述声像图特征相对应。结论:超声对PTB的术前诊断、鉴别诊断和术后随访具有一定的临床价值,尤其CDFI显示肿瘤的血供情况能为临床提供重要的诊断依据。
OBJECTIVE: To improve the understanding of this disease by analyzing the ultrasonographic features of the lobular tumor of the breast (PTB) and its pathological basis. Methods: A retrospective analysis of 30 patients with breast phyllodes tumor confirmed by surgery and pathology was performed as two-dimensional and color Doppler flow imaging (CDFI) ultrasonography performance and pathological results. Results: Among 30 patients with PTE, 18 were benign, 7 were borderline and 5 were malignant. Two-dimensional ultrasound images of PTB showed obvious lobulation or shallow lobulation of the tumor in 20 cases, oval or oval in 10 cases, with a larger volume, the internal echo is not uniform and the posterior echo enhancement, benign who have envelope boundary clearance The vague boundaries of malignant characteristics. CDFI showed grade 0 ~ Ⅰ blood flow in benign cases and Ⅱ ~ Ⅲ grade in malignant cases, and the resistance index was high (RI≥0.75). PTB pathological features of a large number of interstitial cells of the main expansion and expansion, degeneration and necrosis encroachment enveloped lesions, the pathological basis and the corresponding sonographic features. Conclusion: Ultrasound has certain clinical value in the preoperative diagnosis, differential diagnosis and postoperative follow-up of PTB. In particular, CDFI shows that the blood supply of tumor can provide an important diagnostic basis for clinical diagnosis.