Fleury Eduardo F C, Rinaldi Jose F, Piato Sebastiao, Fleury Jose Carlos V, Roveda Junior Decio
Faculty of Medicine, Santa Casa de Misericordia de São Paulo, São Paulo, SP, Brasil.
Eur Radiol. 2009 Jun;19(6):1337-46. doi: 10.1007/s00330-008-1285-2. Epub 2009 Jan 22.
The aim of this study was to show and correlate the imaging features of breast masses, especially fibroadenomas, using sonoelastography. Two hundred thirty-five patients with 302 breast lesions referred for core needle biopsy participated in the study. All lesions appearing as solid masses on conventional US were included. Out of the included lesions (270), 115 (42.6%) corresponded to histologically confirmed fibroadenomas and 155 (57.4%) to lesions with histologically confirmed diagnoses other than fibroadenomas. These were further subdivided into fibrocystic changes, lesions with low malignancy potential, and malignant lesions. Fibroadenomas were also divided according to histological presentation into three subgroups to allow comparative study based on elastographic scores. All lesions were classified using a four-point scoring system based on ultrasound elastography imaging characteristics. Different presentations were observed for elastographic scores according to histological presentation of fibroadenomas, whereby fibroadenomas with benign characteristics tended to have elastographic classification similar to fibrocystic changes, and complex and hypercellular fibroadenomas had classifications similar to harder lesions. Fibroadenomas are generally classified as category 3 in the BI-RADS lexicon and are the most commonly found lesions in breast biopsies. Sonoelastography can provide additional information to conventional studies and be used as an auxiliary tool in assessing these masses in clinical practice.
本研究的目的是利用超声弹性成像展示乳腺肿块,尤其是纤维腺瘤的成像特征,并进行相关性分析。235例有302个乳腺病变的患者因接受粗针活检而参与本研究。纳入所有在传统超声上表现为实性肿块的病变。在纳入的病变(270个)中,115个(42.6%)经组织学证实为纤维腺瘤,155个(57.4%)为经组织学证实诊断为非纤维腺瘤的病变。这些病变进一步细分为纤维囊性变、低恶性潜能病变和恶性病变。纤维腺瘤也根据组织学表现分为三个亚组,以便基于弹性成像评分进行比较研究。所有病变均根据超声弹性成像特征使用四点评分系统进行分类。根据纤维腺瘤的组织学表现,观察到弹性成像评分有不同表现,其中具有良性特征的纤维腺瘤往往具有与纤维囊性变相似的弹性成像分类,而复杂型和细胞丰富型纤维腺瘤的分类与硬度较高的病变相似。纤维腺瘤在BI-RADS词典中通常被分类为3类,是乳腺活检中最常见的病变。超声弹性成像可为传统研究提供额外信息,并可作为临床实践中评估这些肿块的辅助工具。