纤维腺瘤、巨大纤维腺瘤和叶状肿瘤的鉴别诊断：超声特征和粗针活检。
Differential diagnosis between fibroadenoma, giant fibroadenoma and phyllodes tumour: sonographic features and core needle biopsy.
机构信息
Dipartimento di Internistica Clinica e Sperimentale "Magrassi-Lanzara", Sezione di Radiodiagnostica e Radioterapia, Seconda Università degli Studi di Napoli, P.zza Miraglia 2, 80138 Napoli, Italy.
出版信息
Radiol Med. 2011 Sep;116(6):905-18. doi: 10.1007/s11547-011-0672-y. Epub 2011 Apr 19.
PURPOSE
The aim of this study was to analyse mammographic and ultrasound (US) features of fibroadenoma and phyllodes tumour and assess the diagnostic accuracy of mammography, US and US-guided core needle biopsy (CNB) in the differential diagnosis of these two lesions.
MATERIALS AND METHODS
The results of the pathological analysis of excision biopsy of 83 lesions (67 fibroadenomas and 16 phyllodes tumours) were correlated with the findings of mammography, US and US-guided CNB performed on 83 women with a mean age of 45.4 years (range 18-75 years).
RESULTS
Sensitivity, specificity and positive predictive values compared with histology were 45%, 50% and 79% for mammography, 34%, 69% and 82% for US and 81%, 97% and 87% for US-guided CNB (p=0.001).
CONCLUSIONS
The almost complete overlap between mammographic and US parameters of fibroadenomas and phyllodes tumours and the absence of pathognomonic features preclude the differential diagnosis between the two histological types. US-guided CNB is a valuable tool in the differential diagnosis between fibroadenoma and phyllodes tumour.
目的
本研究旨在分析纤维腺瘤和叶状肿瘤的乳腺 X 线摄影和超声（US）特征，并评估乳腺 X 线摄影、US 及 US 引导下核心针活检（CNB）在这两种病变鉴别诊断中的诊断准确性。
材料与方法
对 83 例经手术切除活检的病变（67 例纤维腺瘤和 16 例叶状肿瘤）的病理分析结果与 83 例平均年龄 45.4 岁（18-75 岁）女性的乳腺 X 线摄影、US 及 US 引导下 CNB 检查结果进行了相关性分析。
结果
与组织学相比，乳腺 X 线摄影的敏感性、特异性和阳性预测值分别为 45%、50%和 79%，US 分别为 34%、69%和 82%，US 引导下 CNB 分别为 81%、97%和 87%（p=0.001）。
结论
纤维腺瘤和叶状肿瘤的乳腺 X 线摄影和 US 参数几乎完全重叠，且缺乏特征性表现，这使得两种组织学类型之间的鉴别诊断变得非常困难。US 引导下 CNB 是鉴别纤维腺瘤和叶状肿瘤的一种有价值的工具。
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