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高分辨率压缩弹性成像与彩色多普勒超声在乳腺纤维瘤特征性诊断中的应用

High resolution compression elastography and color doppler sonography in characterization of breast fibroadenoma.

作者信息

Rjosk-Dendorfer D, Reu S, Deak Z, Hetterich H, Kolben T, Reiser M, Clevert D A

机构信息

Department for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.

Institute of Pathology, Ludwig-Maximilians-University, Munich, Germany.

出版信息

Clin Hemorheol Microcirc. 2014;58(1):115-25. doi: 10.3233/CH-141884.

DOI:10.3233/CH-141884
PMID:25227197
Abstract

PURPOSE

To evaluate the use of color Doppler sonography and free hand sonoelastography in the assessment of breast fibroadenomas according to their size and shape.

MATERIALS AND METHODS

From December 2012 to March 2013 women with 16 solid breast masses, classified as BI-RADS category 3 or 4 were examined with B-mode ultrasound, sonoelastography and color Doppler sonography. Lesions were subdivided according to their shape in round, ovoid or macrolobulated and according to their size (<2.0 cm or ≥2.0 cm). Two readers assessed sonoelastographic findings at 12.5 MHz using the tsukuba elasticity score and results of Doppler sonography using a score of 0, 1 or 2, depending on the degree of perfusion.

RESULTS

Among the 16 examined lesions 3 showed a round shape, 9 were ovoid and in 4 cases a macrolobulated appearance could be seen. No significant differences concerning Tsukuba-score depending on various shapes of fibroadenomas in B-mode sonography could be shown (p = 0.91) and also comparison of Tsukuba-scores and size of masses revealed no significant differences (p = 1.0). Sizes of fibroadenomas ≥2 cm were significantly associated with an increased vascularization of the lesions (p = 0.04) and a macrolobulated appearance in B-mode sonography (p = 0.04).

CONCLUSION

The combination of color Doppler sonography and sonoelastography in addition to B-mode sonography leads to an increased accuracy in distinguishing benign from malignant breast masses and to an improvement in characterization of fibroadenomas independent of their shape or size.

摘要

目的

根据乳腺纤维瘤的大小和形状,评估彩色多普勒超声和徒手超声弹性成像在其评估中的应用。

材料与方法

2012年12月至2013年3月,对16例实性乳腺肿块患者进行检查,这些肿块被分类为BI-RADS 3类或4类,采用B超、超声弹性成像和彩色多普勒超声检查。病变根据其形状分为圆形、椭圆形或分叶状,根据其大小分为<2.0 cm或≥2.0 cm。两名阅片者使用筑波弹性评分评估12.5 MHz的超声弹性成像结果,根据灌注程度使用0、1或2分对多普勒超声结果进行评分。

结果

在16个检查的病变中,3个呈圆形,9个为椭圆形,4个可见分叶状外观。在B超中,根据纤维瘤的不同形状,筑波评分无显著差异(p = 0.91),筑波评分与肿块大小的比较也无显著差异(p = 1.0)。≥2 cm的纤维瘤大小与病变血管化增加(p = 0.04)和B超中的分叶状外观显著相关(p = 0.04)。

结论

除B超外,彩色多普勒超声和超声弹性成像相结合可提高鉴别乳腺良恶性肿块的准确性,并改善对纤维瘤的特征描述,而与它们的形状或大小无关。

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引用本文的文献

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An Evaluation of Ultrasound Features of Breast Fibroadenoma.乳腺纤维瘤超声特征的评估
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[Sonoelastography in daily clinical routine].日常临床实践中的超声弹性成像
Radiologe. 2017 May;57(5):356-365. doi: 10.1007/s00117-017-0224-0.