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目的 重点分析小乳癌(直径≤2.0cm)的二维超声及彩色多普勒等综合超声指标,旨在探讨超声对小乳癌的诊断价值。方法 36例小乳癌经二维超声了解其形态、边缘、边界、内部回声、有无微小钙化点、后方衰减情况以及患侧腋窝淋巴结是否肿大。然后用彩色多普勒观察肿块内部及周边有无血流,并根据其丰富程度分成0、1、2、3四个等级。必要时行超声导向穿刺活检。结果 二维超声仅边界不清,呈“恶性晕”一项为80.6％(29/36),其余图像特征表现不明显。癌块血流信号检出率为75％(27/36),2+3级为52.8％(19/36)。本组中11例癌块内探及细小钙化点;5例探及患侧腋窝淋巴结肿大。10例行超声导向穿刺病灶细胞学检查,9例诊断为乳腺癌。结论 小乳癌的超声诊断应以二维图像中的边界回声为基础,同时结合肿块内的血流信号,再加上微小钙化点,肿大淋巴结以及p/u比值等综合分析,必要时超声导向穿刺活检,可提高小乳癌的正确诊断率。
Objective To analyze two-dimensional ultrasonography and color Doppler sonography of small breast cancer (diameter ≤2.0cm) and to evaluate the diagnostic value of ultrasound in small breast cancer. Methods Twenty-six cases of small breast cancer were analyzed by two-dimensional ultrasonography to understand its morphology, margins, borders, internal echoes, presence or absence of microcalcification, posterior attenuation, and whether the affected axillary lymph nodes were swollen. Color Doppler was then used to observe the presence and absence of blood flow within and around the mass, and divided into four levels of 0, 1, 2, and 3 according to their abundance. Ultrasound-guided biopsy is performed when necessary. Results The two-dimensional ultrasound only had unclear boundaries, and the “malignant halo” was 80.6% (29/36). The rest of the image features were not obvious. The detection rate of blood flow signal in cancer mass was 75% (27/36), and 52.8% (19/36) in 2+3. In this group, 11 cases of intracranial exploration and small calcifications; 5 cases of ipsilateral axillary lymph nodes. Ultrasound-guided puncture cytology was performed in 10 cases, and 9 cases were diagnosed as breast cancer. Conclusion Ultrasound diagnosis of small breast cancer should be based on boundary echoes in two-dimensional images, combined with blood flow signals within the masses, combined with comprehensive analysis of microcalcification, enlarged lymph nodes, and p/u ratio, etc. Puncture biopsy can improve the correct diagnosis rate of small breast cancer.