Nam Sang Yu, Ko Eun Sook, Han Boo-Kyung, Shin Suyoung, Ko Eun Young, Shin Jung Hee, Hahn Soo Yeon
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Department of Radiology, Gil Hospital, Gachon University of Medicine and Science, Incheon, Republic of Korea.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Acta Radiol. 2015 Jan;56(1):18-24. doi: 10.1177/0284185113512482. Epub 2013 Nov 19.
Most of the breast lesions show hypoechogenicity relative to fat on ultrasonography. The frequency and malignancy rate of hyperechoic lesions are not investigated in a large series.
To evaluate the frequency and malignancy rate of hyperechoic lesions on breast sonography and to investigate sonographic characteristics that may predict malignancy in hyperechoic breast lesions.
Radiologic reports of 16,416 patients who underwent breast sonography between 2007 and 2008 were searched using "hyperechoic", "echogenic" or "heterogeneous echoic" to describe lesions. Sonographic findings were evaluated according to the Breast Imaging Reporting and Data System lexicon. Clinical records including follow-up and pathologic findings were also reviewed. We calculated the frequency of hyperechoic lesions and their malignancy rate. Differences in sonographic appearances between benign and malignant lesions were also investigated.
Among the 16,416 patients, 103 (0.6%) hyperechoic lesions were identified (mean size, 1.79 cm). Of these 103 lesions, 27 (26.2%) were pathologically evaluated and five (4.9%, 4 invasive ductal carcinoma and 1 mucinous carcinoma) were confirmed as malignant. Among the 819 malignant lesions diagnosed using sonography-guided core needle biopsy, five (0.6%) were hyperechoic. In benign lesions, fat necrosis and fibroadenoma were common pathologic diagnoses. Malignant lesions were more likely to have irregular shape (P = 0.003), non-parallel orientation (P = 0.002), non-circumscribed margin (P = 0.007), and a hypoechoic area (P = 0.027) than benign lesions. All hyperechoic carcinomas were seen as suspicious masses on mammograms.
Hyperechoic masses are very rare and mostly benign. As an adjunct to mammography, the imaging findings reported here could help to avoid misdiagnosis for malignant hyperechoic lesion.
大多数乳腺病变在超声检查中相对于脂肪表现为低回声。高回声病变的发生率和恶性率尚未在大样本中进行研究。
评估乳腺超声检查中高回声病变的发生率和恶性率，并研究可能预测高回声乳腺病变恶性的超声特征。
检索2007年至2008年间接受乳腺超声检查的16416例患者的放射学报告，使用“高回声”、“回声增强”或“不均匀回声”来描述病变。根据乳腺影像报告和数据系统词典评估超声检查结果。还回顾了包括随访和病理结果在内的临床记录。我们计算了高回声病变的发生率及其恶性率。还研究了良性和恶性病变在超声表现上的差异。
在16416例患者中，发现103例（0.6%）高回声病变（平均大小为1.79 cm）。在这103例病变中，27例（26.2%）进行了病理评估，5例（4.9%，4例浸润性导管癌和1例黏液癌）被确诊为恶性。在819例经超声引导下粗针穿刺活检诊断为恶性的病变中，5例（0.6%）为高回声。在良性病变中，脂肪坏死和纤维腺瘤是常见的病理诊断。与良性病变相比，恶性病变更可能具有不规则形状（P = 0.003）、非平行方向（P = 0.002）、边界不清（P = 0.007）和低回声区（P = 0.027）。所有高回声癌在乳腺钼靶片上均表现为可疑肿块。
高回声肿块非常罕见，大多为良性。作为乳腺钼靶检查的辅助手段，本文报道的影像学表现有助于避免对高回声恶性病变的误诊。
