Cox B A, Kelly K M, Ko P, Hertzog L, Stain S C
Department of Medical Education, Huntington Memorial Hospital, Pasadena, California 91109, USA.
Am Surg. 1998 Oct;64(10):934-8.
Recent advances in ultrasound technology, such as the use of high-frequency linear transducers, color flow Doppler, and computer-enhanced imaging, have improved the diagnostic utility of ultrasound. The following retrospective study was performed to evaluate the efficacy of sonographic signs of malignancy and to compare sonography to mammography in 157 patients with palpable, biopsy-proven breast carcinomas. The mammogram reports and sonograms were all reviewed. The grade of each mammogram was recorded using the American College of Radiology mammogram grading scale. All sonograms were reviewed and assigned a score using an adaptation of this scale. Of 157 lesions, 121 were read as suspicious or probable malignancies on mammogram. Thirty-three lesions were read as benign or normal on mammogram. Three patients did not receive mammograms. All 157 lesions were read as either suspicious or probably malignant on ultrasound. Using the 16 described criteria, high-definition sonography complements mammography and appears to be a sensitive modality in the evaluation of palpable biopsy-proven breast malignancies. The diagnostic utility of ultrasound will likely be most important in the evaluation of nonpalpable breast masses; however, a prospective randomized trial will need to be performed.
超声技术的最新进展，如高频线性换能器的使用、彩色多普勒血流成像以及计算机增强成像，提高了超声的诊断效用。进行了以下回顾性研究，以评估恶性超声征象的有效性，并在157例经活检证实为可触及乳腺癌的患者中将超声与乳腺X线摄影进行比较。对乳腺X线摄影报告和超声图像进行了全面回顾。使用美国放射学会乳腺X线摄影分级量表记录每张乳腺X线摄影的分级。对所有超声图像进行回顾，并使用该量表的改编版本进行评分。在157个病灶中，121个在乳腺X线摄影中被读为可疑或可能为恶性。33个病灶在乳腺X线摄影中被读为良性或正常。3例患者未接受乳腺X线摄影。所有157个病灶在超声检查中均被读为可疑或可能为恶性。使用所描述的16项标准，高清超声可补充乳腺X线摄影，并且在评估经活检证实的可触及乳腺恶性肿瘤方面似乎是一种敏感的检查方法。超声的诊断效用在评估不可触及的乳腺肿块时可能最为重要；然而，需要进行一项前瞻性随机试验。
