林梅艳 王志英

[摘要] 目的 探讨超声在触诊阳性非肿块型乳腺病变中的诊断价值。方法 方便选取该院从2017年2月—2019年2月收治的102例非肿块性乳腺病变患者，均行超声检查及病理血检查。 结果102例患者中，恶性病变73例，良性病变29例。以病理诊断结果为金标准，超声诊断的灵敏度、特异度、诊断符合率分别为82.19%、82.76%、82.35%。超声表现多以不含钙化和含散在钙化的低回声为主，分别占56.86%和32.35%。非肿块性乳腺良性病变以局灶性多见（占71.88%）、恶性病变以节段性多见（占91.43%）;良性病变以无钙化病灶多见（46.55%）、恶性病变以钙化病灶多见（占93.94%）;良性病变多无彩色血流（占57.14%）、恶性病变多见彩色血流（占76.09%），良性病变以≤3分多见（占36.11%），恶性病变以≥4分多见（占90.00%），差异有统计学意义（χ2=43.250、21.845、18.374、7.095， P<0.05）。 结论 超声在触诊阳性非肿块型乳腺病变中的诊断中的灵敏度和准确率较高。

[关键词] 超声;乳腺肿瘤;非肿块型乳腺病变

[中图分类号] R655.8;R445.1          [文献标识码] A          [文章编号] 1674-0742（2020）04（a）-0190-03

[Abstract] Objective To explore the diagnostic value of ultrasound in palpation-positive non-mass breast lesions. Methods Convenient select 102 patients with non-mass breast lesions admitted to our hospital from February 2017 to February 2019 were examined by ultrasonography and pathological blood. Results Among 102 patients， 73 were malignant and 29 were benign. The sensitivity， specificity and coincidence rate of ultrasonography were82.19%，82.76% and 82.35%.Most of the ultrasonographic findings were calcified and calcified hypoechoic， accounting for 56.86% and 32.35% respectively.The benign lesions of mass breast were mostly focal （71.88%） and malignant lesions were segmental （91.43%）; benign lesions were mostly non-calcified（46.55%）; malignant lesions were mostly calcified （93.94%）; benign lesions were mostly non-colored（57.14%） and malignant lesions were mostly colored（76.09%）， benign lesions ≤3 points were more common （36.11%） and malignant lesions ≥4 points were more common（90.00%）. The difference was statistically significant（χ2=43.250， 21.845， 18.374， 7.095， P<0.05）.  Conclusion Ultrasound has higher sensitivity and accuracy in palpation positive non-mass breast lesions.

[Key words] Ultrasound; Breast neoplasms; Non-mass breast lesions

超声技术的发展，使乳腺病变的诊断准确率大大提高。乳腺病变一般分为肿块型、钙化型和特殊病变，其中以肿块型病变最为常见，也最为典型。非肿块型乳腺病变超声图像上无明确的边界，且在两个不同的扫查方向上不具备空间占位效应现象[1]，无典型特征，加之乳腺病变种类较多，给诊断增加了很大难度。其在超声上的的表现多为： 导管内低回声区、片状低回声区、散在分布的微钙化区、结构紊乱。该文对该院从2017年2月—2019年2月收治的102例非肿块性乳腺病变患者的超声特征进行分析，以为临床诊断提供参考和依据，现报道如下。

1  资料与方法

1.1  一般资料

方便选择该院收治的102例非肿块性乳腺病变患者，均为女性，年龄23～68岁，平均（49.72±3.58）岁，病灶直径0.6～8.5cm，平均（4.05±0.87）cm。……