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男性乳腺癌多模式超声影像学特征分析
赵佳琦1,何金2,章建全1*
0
(1.第二军医大学长征医院超声诊疗科,上海 200003;2.第二军医大学长征医院病理科,上海 200003)
摘要:
目的:观察男性乳腺癌多种模式超声影像学特征表现,探讨其诊断意义及鉴别诊断要点。方法:回顾性分析8例经手术和(或)超声引导下穿刺病理证实为乳腺癌的男性患者病例资料,总结其二维成像、三维重建、彩色多普勒血流显像(CDFI)、超声造影(CEUS)等多种模式下的超声影像学特征,并与同期确诊的7例男性乳腺增生患者的病例资料进行对照研究,探讨诊断意义,总结诊断要点。结果:(1)二维声像图:7例乳腺增生表现为弥漫性包块者,超声诊断与病理诊断符合率为6/7;8例均单发的单侧局灶性包块者,超声诊断均为乳腺癌,表现为肿块回声低、形态不规则、伴同侧腋窝淋巴结异常肿大(3例),可见明显的沙砾样钙化(3例),与病理完全符合(8/8)。(2)CDFI及CEUS:腺体增生者血流信号多不丰富,乳腺癌则全部显示丰富的血流信号;高频CEUS仅显示3例显著增强,而低频CEUS显示全部显著增强。(3)三维重建:局灶性乳腺癌中2例(2/8)可见三维冠状切面汇聚征。结论:多模式超声影像有助于全面把握男性乳腺疾病信息,对男性乳腺癌的早发现、早诊断、早治疗具有积极意义。
关键词:  超声检查  超声造影  汇聚征  男性乳腺肿瘤
DOI:10.3724/SP.J.1008.2009.0917
投稿时间:2009-03-22修订日期:2009-06-28
基金项目:第二军医大学长征医院“三重三优”学科和人才建设专项基金(20050316).
Multi-mode ultrasound analysis of male breast cancer
ZHAO Jia-qi1,HE Jin2,ZHANG Jian-quan1*
(1.Department of Ultrasound,Changzheng Hospital,Second Military Medical University,Shanghai 200003,China;2.Department of Pathology,Changzheng Hospital,Second Military Medical University,Shanghai 200003)
Abstract:
Objective:To analyze the multi-mode ultrasound manifestation of male breast cancer,and to discuss its value in clinical diagnosis and differential diagnosis.Methods: The clinical data of 15 male patients with pathologically-confirmed breast cancer were retrospectively reviewed.All the patients were examined by multi-mode ultrasound (including 2D,3D,color Doppler flow imaging \[CDFI\],and intravenous contrast-enhanced ultrasound \[CEUS\]).The ultrasonic characteristics of the 8 patients were compared with those of 7 patients with hyperplasia.The diagnostic values of the ultrasonic characteristics were summarized.Results: (1) 2D sonogram:6 of 7 cases with ultrasonically diffused masses,which were all initially interpreted as hyperplasia on ultrasound,were confirmed pathologically,with an accurate rate of 86%.All the 8 patients had unilateral focal masses (ipsilateral in 3 of 8).They were all diagnosed as having breast cancer by ultrasound,with hypoechoes and irregular shape.Three of them had micro-calcification.All the 8 patients were confirmed to have breast cancer pathologically,with the accurate rate of ultrasound being 100%.(2) CDFI and CEUS:hyperplasia patients had weak blood flow signal and breast cancer patients all had rich blood flow signal.High frequency CEUS showed that only 3 breast cancer patients had marked micro-vascular enhancement,while low-frequency CEUS showed prominent enhancement in all cancer cases.(3) 3D reconstruction:coronary display of 2 focal masses showed “convergent sign”.Conclusion: Multi-mode ultrasound imaging can provide comprehensive information of male patients with breast disorders; it may facilitate the early detection,early diagnosis and early treatment for male breast cancer.
Key words:  ultrasonography  contrast-enhanced ultrasound  convergent sign  male breast neoplasms