Lange T A, Austin C W, Seibert J J, Angtuaco T L, Yandow D R
J Bone Joint Surg Am. 1987 Jan;69(1):100-5.
Fifty patients who had a palpable soft-tissue mass and an apparently normal radiograph were studied with ultrasound imaging before excision or biopsy of the lesion was done. As shown by the sonograms, thirty-five lesions had a discrete echo pattern (usually reduced echoes and a clearly defined lesional margin) and fifteen had an ill defined pattern (similar to the pattern of the surrounding normal tissues with no definable lesional margin). Fourteen lesions were malignant and thirty-six, benign. The sonograms of all fourteen malignant lesions showed a discrete pattern, while the sonograms of the benign ones showed twenty-one discrete and fifteen ill defined patterns. Therefore, the malignant lesions produced a discrete pattern in every instance, and every lesion that produced an ill defined pattern was benign. Fourteen of the fifty lesions were cystic; of these, thirteen were benign and one was malignant. The sonograms correctly identified the cyst in seven of the thirteen benign lesions and in the one malignant cystic lesion. Based on these findings, we concluded that all palpable soft-tissue masses that appear to be discrete on a sonogram should be diagnosed without delay by examination of a specimen taken at biopsy, whereas lesions that have an ill defined appearance on a sonogram may be assumed to be benign and may safely be observed in selected patients.
对50例可触及软组织肿块且X线片表现正常的患者，在对病变进行切除或活检之前，先用超声成像进行了研究。超声检查显示，35个病变具有离散回声模式（通常回声减弱且病变边缘清晰），15个病变具有边界不清的模式（类似于周围正常组织的模式，无明确的病变边缘）。14个病变为恶性，36个为良性。所有14个恶性病变的超声检查均显示离散模式，而良性病变的超声检查显示21个离散模式和15个边界不清的模式。因此，恶性病变在每种情况下均产生离散模式，而产生边界不清模式的每个病变均为良性。50个病变中有14个为囊性；其中，13个为良性，1个为恶性。超声检查在13个良性病变中的7个以及1个恶性囊性病变中正确识别出了囊肿。基于这些发现，我们得出结论，超声检查显示为离散的所有可触及软组织肿块应通过活检获取的标本检查立即进行诊断，而超声检查外观边界不清的病变可被认为是良性的，在特定患者中可安全观察。
