CAJ | 학술논문

目的探讨非肿块型乳腺癌的自动乳腺全容积成像(ABVS)表现.方法回顾性分析49例经手术病理证实的非肿块型乳腺癌,分析病灶的内部回声特点、有无钙化、冠状面特征及周边改变情况,并参照乳腺影像报告和数据系统(BI-RADS)进行评估分类.结果 49例非肿块型乳腺癌中,导管原位癌27例(55.10％),浸润性导管癌21例(42.86％),浸润性小叶癌1例(2.04％).ABVS影像表现:伴或不伴增厚的片状低回声区43例(87.76％),散在或簇状分布的微钙化41例(83.67％),冠状面呈“汇聚征”6例(12.24％),1例(2.04％)有皮肤增厚、皮下水肿.导管原位癌与浸润性导管癌相比较:导管原位癌内微钙化的检出率略高(85.19％对80.95％,P=0.715),冠状面呈“汇聚征”则以浸润性导管癌出现率高(19.05％对7.41％,P=0.383),但差异均无统计学意义(P＞0.05).BI-RADS-ABVS分类,44例术前BI-RADS分级为4a～5级,5例术前诊断为0～2级,诊断符合率89.80％.结论非肿块型乳腺癌的ABVS影像表现有一定的特点,片状低回声区、微钙化、冠状面“汇聚征”等均是非肿块型乳腺癌的重要征象,注重非肿块型乳腺癌这些征象的观察和分析,可以提高检出率和减少漏诊率.
목적 탐토비종괴형유선암적자동유선전용적성상(ABVS)표현.방법 회고성분석49례경수술병리증실적비종괴형유선암,분석병조적내부회성특점、유무개화、관상면특정급주변개변정황,병삼조유선영상보고화수거계통(BI-RADS)진행평고분류.결과 49례비종괴형유선암중,도관원위암27례(55.10％),침윤성도관암21례(42.86％),침윤성소협암1례(2.04％).ABVS영상표현:반혹불반증후적편상저회성구43례(87.76％),산재혹족상분포적미개화41례(83.67％),관상면정“회취정”6례(12.24％),1례(2.04％)유피부증후、피하수종.도관원위암여침윤성도관암상비교:도관원위암내미개화적검출솔략고(85.19％대80.95％,P=0.715),관상면정“회취정”칙이침윤성도관암출현솔고(19.05％대7.41％,P=0.383),단차이균무통계학의의(P＞0.05).BI-RADS-ABVS분류,44례술전BI-RADS분급위4a～5급,5례술전진단위0～2급,진단부합솔89.80％.결론 비종괴형유선암적ABVS영상표현유일정적특점,편상저회성구、미개화、관상면“회취정”등균시비종괴형유선암적중요정상,주중비종괴형유선암저사정상적관찰화분석,가이제고검출솔화감소루진솔.
Objective To analyze sonographic characteristics of the automated breast volume scanner (ABVS) in non-mass-like breast carcinoma.Methods 49 patients with non-mass-like breast carcinoma were confirmed by pathology after operation.All of the patients underwent ABVS,the sonographic characteristics of internal echo and microcalcifications in the lesions,the retraction phenomenon in coronal plane and surrounding change were analyzed.All the lesions were assessed by breast imaging reporting and data system (BI-RADS).Results In 49 patients with non-mass-like breast carcinoma,27(55.10％) cases were ductal carcinoma in situ,21 (42.86％) cases were infitrating ductal carcinoma,and 1 (2.04％) case were infitrating lobular carcinoma.The findings of ABVS:43 (87.76 ％) lesions appeared as segmental hypoechoic areas,41 (83.67％) lesions appeared as scattered or clustered microcalcifications,6(12.24％) lesions appeared as the retraction phenomenon in coronal plane,and 1 (2.04％) lesion appeared as pachyderma and subcutaneous dropsy.Microcalcifications in ductal carcinoma in situ appeared more than that in infitrating ductal carcinoma (85.19 ％ vs 80.95 ％,P =0.715) ;the retraction phenomenon in coronal plane of infitrating ductal carcinoma were higher than that of ductal carcinoma in situ(19.05％ vs 7.41％,P =0.383),but there were no significant difference in those between ductal carcinoma in situ with infitrating ductal carcinoma(P ＞0.05).All the cases were assessed according to BI-RADS,including 4a-5 category 44 cases,0-2 category 5 cases.The coincidence rate in diagnosis of ABVS were 89.80％.Conclusions The ABVS features of non-mass-like breast carcinoma are characteristic.Segmental hypoechoic areas,microcalcifications and the retraction phenomenon in coronal plane are important for the diagnosis of non-mass-like breast carcinoma,ABVS can improve the detect ability and decrease the missed diagnosis of non-mass-like breast carcinoma.