彩色多普勒超声在乳腺良恶性肿瘤鉴别诊断中的应用价值

彩色多普勒超声在乳腺良恶性肿瘤鉴别诊断中的应用价值

蔡永萍

四川省会理市妇幼保健计划生育服务中心（会理市妇幼保健院）, 四川凉山彝族自治州615100

【摘要】目的：观察在乳腺良恶性肿瘤鉴别诊断中彩色多普勒超声所展现出来的诊断价值。方法：选取130例确诊为乳腺肿瘤疾病患者，就诊时间为2020年1月-2022年1月，观察病理检查良恶性肿瘤超声鉴别诊断结果，超声诊断方法下,良恶性肿瘤超声表现及超声多普勒指标。结果：经病理诊断，130例乳腺肿瘤中，良性有94例，恶性有36例。恶性肿瘤患者的钙化、回声不均匀、局部充盈缺损、形态不规则、边界不清晰,概率高于良性肿瘤患者（P＜0.05）。良性肿瘤超声多普勒指标低于恶性肿瘤（P＜0.05）。结论：在乳腺良恶性肿瘤鉴别诊断中,应用彩色多普勒超声诊断方法，以血流动力学及形态学特征为依据,对疾病进行诊断，疾病诊断准确率高，为临床治疗疾病提供了可靠的依据，推荐在                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         临床诊断中大力使用。

【关键词】乳腺良恶性肿瘤；彩色多普勒超声；超声表现

    乳腺疾病是妇科中一种发病率较高的疾病，疾病类型包括乳腺炎、乳腺增生、乳腺纤维瘤、乳腺囊肿、乳腺癌等。引发乳腺肿瘤产生的原因较为复杂，且发病率有逐年上升趋势，在发病后若不能及时接受治疗，或者治疗方法不正确，患者病情会进一步恶化，严重者还会对患者的生活和生命安全造成极大的威胁[1]。因此，为了能够使疾病得到合理化的治疗措施，尽早对疾病的良恶性进行诊断尤为重要。当前，倡导在乳腺良恶性肿瘤疾病诊断中，使用彩色多普勒超声诊断方法，该种诊断方法本身属于一种新型的诊断方法，具有安全性高、无创性及可重复性等优势，在疾病诊断中发挥了重要的作用[2]。

1资料与方法

1.1一般资料

选取130例确诊为乳腺肿瘤疾病患者，就诊时间为2020年1月-2022年1月，年龄为24-65（48.5±2.6）岁；肿瘤直径12-46（19.56±4.10）mm。纳入标准：①本次研究选取的所有患者均经病理诊断确诊为乳腺肿瘤疾病；②患者的临床症状表现为皮肤凹陷、乳头溢液及乳房变色。排除标准：①感染性疾病者；②临床资料不完整者；③其他部位存在肿瘤疾病；④严重脏器疾病者；⑤对超声造影剂过敏者。本次研究活动在经过医院伦理委员会的批准通过后进行，患者知情本次研究活动，并自愿加入进来。

1.2方法

    使用彩色多普勒超声对患者进行诊断，使用的诊断仪器为GE Voluson E8型彩色多普勒超声诊断仪对患者进行诊断。将超声的探头频率设置为7.5-12MHz，在对患者进行检查期间，要求患者应保持合适的体位，一般应保持仰卧位姿势，要求患者应展开双臂，并充分显露出乳房、腋窝及锁骨，并在乳房表面涂抹耦合剂，将超声探头放置在乳房上，对患者的乳房进行纵向、横向及放射状扫查。并仔细观察乳腺肿块血流情况、内部回声、有无钙化、形态及边界情况，并观察腋窝有无淋巴结肿大等情况。

1.3观察指标

观察病理检查良恶性肿瘤超声鉴别诊断结果。观察良恶性肿瘤超声表现，包括钙化、回声不均匀、局部充盈缺损、形态不规则、边界不清晰。观察良恶性肿瘤患者的超声多普勒指标，包括RI（血流阻力指数）、PSV（血流峰值血流速度）、PI（搏动指数）三种。

1.4统计学处理

采用SPSS22.0软件进行统计分析，（±s）用于表示计量资料，用t检验；（%）用于表示计数资料，用检验，差异显著（P＜0.05）。

2结果

2.1良恶性肿瘤超声鉴别诊断结果

经病理诊断，130例乳腺肿瘤中，良性有94例，其中，纤维腺瘤有36例，脂肪瘤有32例，导管内乳头瘤有26例。恶性有36例，其中，浸润性导管癌有12例，小叶原位癌有8例，单纯癌有9例，髓样癌有7例。

2.2良恶性肿瘤超声表现

恶性肿瘤患者的钙化、回声不均匀、局部充盈缺损、形态不规则、边界不清晰概率高于良性肿瘤患者（P＜0.05）。

表 1 良恶性肿瘤超声表现[n(%)]

2.3超声多普勒指标

良性肿瘤超声多普勒指标低于恶性肿瘤（P＜0.05）。

表 2 超声多普勒指标（±s）

3讨论

    使用彩色多普勒超声诊断方法，对乳腺良恶性肿瘤疾病进行诊断，从超声图像上可以看出，良性肿瘤为肿块部位处存在包膜，形态规则，呈圆形或椭圆形，边界清晰，内部展现出了均匀的回声，并且后方回声衰减不明显。恶性肿瘤为肿块呈现出一种浸润性生长为主要生物学特点，会对周围组织造成极大的影响，且形态不规则，与周围组织边界不清晰，后方回声呈现出一种衰减状态[3]。

    本文研究结果为，经病理诊断，130例乳腺肿瘤中，良性有94例，恶性有36例。恶性肿瘤患者的钙化、回声不均匀、局部充盈缺损、形态不规则、边界不清晰概率高于良性肿瘤患者（P＜0.05）。良性肿瘤超声多普勒指标低于恶性肿瘤（P＜0.05）。由此可知，彩色多普勒超声在乳腺良恶性肿瘤疾病诊断中展现出了显著的应用效果，为良恶性肿瘤诊断提供了科学的依据。

    综上所述，在乳腺良恶性肿瘤鉴别诊断中，应用彩色多普勒超声诊断方法，以血流动力学及形态学特征为依据对疾病进行诊断，疾病诊断准确率高，为临床治疗疾病提供了可靠的依据，推荐在临床诊断中大力使用。

【参考文献】

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[2]王巧玉.彩色多普勒超声在乳腺良恶性肿瘤鉴别诊断中的应用研究[J].航空航天医学杂志,2021,32(02):161-162.

[3]侯奕楠.彩色多普勒超声在乳腺良恶性肿瘤鉴别诊断中的应用研究[J].影像研究与医学应用,2020,4(05):218-219.