Kim Tae Hee, Kang Doo Kyoung, Kim Sun Yong, Lee Eun Ju, Jung Yong Sik, Yim Hyunee
Department of Diagnostic Radiology, Ajou University Medical Center, Yongtong-Gu, Suwon, Kyongi-Do, Korea.
J Ultrasound Med. 2008 Jan;27(1):75-82. doi: 10.7863/jum.2008.27.1.75.
The purpose of this study was to evaluate sonographic findings of breast papillary lesions and the effectiveness of the American College Radiology Breast Imaging Reporting and Data System sonographic assessment system for differentiation of benign and malignant papillary lesions.
We retrospectively reviewed breast sonographic findings of 46 surgically proven benign papillomas and 22 papillary carcinomas. All sonographic images of patients were interpreted by 2 radiologists. Sonographic findings were analyzed according to the Breast Imaging Reporting and Data System classification.
The shape of the lesion was round or oval in 33 benign lesions (71.7%) and 13 papillary carcinomas (61.9%). As for the margin, a circumscribed margin was found in 31 benign papillomas (67.4%) and 12 malignant lesions (57.1%). Differences in the predominant shape and margin between the 2 groups were not statistically significant (P > .05). Fourteen benign papillomas (30.5%) and 12 papillary carcinomas (57.1%) showed a complex echo pattern. It was more frequently observed in malignant lesions; however, it was not statistically significant (P = .09). A nonparallel orientation, an echogenic halo, posterior acoustic enhancement, and associated microcalcification were more frequently found in malignant than in benign lesions (P < .05). When the presence of any suspicious sonographic feature (nonparallel orientation, echogenic halo, posterior enhancement, or calcification) was considered to indicate malignancy, interpretation of the sonographic features gave sensitivity of 85.7%, specificity of 64.9%, a positive predictive value of 47.4%, and a negative predictive value of 92.5% for detection of malignant papillary lesions. The only differential finding between noninvasive and invasive papillary cancers was a circumscribed margin (P < .05).
Sonographic features more specific to malignancy include a nonparallel orientation, an echogenic halo, posterior acoustic enhancement, and associated microcalcification.
本研究旨在评估乳腺乳头状病变的超声表现，以及美国放射学会乳腺影像报告和数据系统超声评估系统对鉴别良性和恶性乳头状病变的有效性。
我们回顾性分析了46例经手术证实的良性乳头状瘤和22例乳头状癌的乳腺超声表现。所有患者的超声图像均由2名放射科医生解读。根据乳腺影像报告和数据系统分类对超声表现进行分析。
33例良性病变（71.7%）和13例乳头状癌（61.9%）的病变形态为圆形或椭圆形。至于边缘，31例良性乳头状瘤（67.4%）和12例恶性病变（57.1%）可见边界清晰的边缘。两组之间主要形态和边缘的差异无统计学意义（P>.05）。14例良性乳头状瘤（30.5%）和12例乳头状癌（57.1%）表现为复杂回声模式。在恶性病变中更常见；然而，差异无统计学意义（P=.09）。与良性病变相比，恶性病变中更常出现非平行方向、回声晕、后方回声增强和相关微钙化（P<.05）。当任何可疑超声特征（非平行方向、回声晕、后方增强或钙化）的存在被认为提示恶性时，超声特征的解读对检测恶性乳头状病变的敏感性为85.7%，特异性为64.9%，阳性预测值为47.4%，阴性预测值为92.5%。非侵袭性和侵袭性乳头状癌之间唯一的鉴别发现是边界清晰的边缘（P<.05）。
更具恶性特异性的超声特征包括非平行方向、回声晕、后方回声增强和相关微钙化。
