超声引导下乳腺穿刺活检的临床应用探讨

目的探讨超声引导下乳腺穿刺活检在临床中的应用价值。方法回顾性分析横沥人民医院超声检查发现乳腺实性占位性病变但不能确定病变性质的78例患者的临床资料。所有患者均行超声引导下穿刺活检,活检采用16G切割穿刺针及自动活检枪,在高频超声引导下经皮穿刺取材,所取组织送病理检查。结果 78例穿刺活检患者中病理报告良性病变62例,恶性病变16例。病例中未见并发症。结论超声引导下乳腺穿刺活检是一种简便易行的诊断方法,适合临床推广应用。     

超声引导下穿刺活检在乳腺非肿块样病变诊断中的应用价值

目的探讨超声引导下穿刺活检在乳腺非肿块样病变中的诊断价值。 方法选取2017年1月至2018年12月杭州市第一人民医院超声科经超声检查评估为乳腺影像报告与数据系统（BI-RADS）4a类及以上的乳腺非肿块样病变患者93例,共计93个病灶。所有病变均行超声引导下穿刺活检,并经手术病理证实。应用四格表计算超声引导下穿刺活检对乳腺非肿块样病变的诊断效能。 结果手术病理结果提示,恶性病灶47个,良性病灶46个。超声引导下穿刺活检结果提示恶性病灶43个,良性50个。穿刺活检漏诊4个恶性病灶,术前超声均提示为BI-RADS 4b,术后病理证实3例为导管原位癌和1例为浸润癌。超声引导下穿刺活检诊断乳腺非肿块样病变的敏感度为91.4%（43/47）,特异度为100.0%（46/46）,假阴性率为8.6%（4/47）,诊断准确性为95.7%（89/93）。 结论超声引导下穿刺活检对乳腺非肿块样病变的诊断存在一定的假阴性率,但敏感度、特异度及准确性均较高,具有良好的诊断价值。     

高频彩超引导粗针穿刺活检在乳腺肿物诊断中的临床应用

目的:评价高频彩超引导下对乳腺肿物进行粗针穿刺活检的临床应用价值.方法:对40例临床疑为乳腺癌者,在高频彩超引导下,采用美国产Bard自动活检枪及16号活检针穿刺乳腺肿物取材,并经病理学检查.结果:每例取材3或4次,获取组织140块,取材满意率为100%,所有病例穿刺活检后无严重并发症.病理诊断结果:乳腺良性病变6例(15%),其中炎性肿物、纤维腺瘤各2例,纤维腺病、肌纤维母细胞瘤各1例.乳腺恶性病变34例(85%),其中浸润性导管癌29例,浸润性小叶癌3例,黏液性腺癌、乳腺不典型增生各1例.结论:高频彩超引导下乳腺肿物穿刺活栓是一种安全、准确、并发症少的介入性超声诊断技术,患者痛苦小、易接受,有较高的临床诊断价值.     

高频超声引导下穿刺活检在小乳癌及乳腺癌前病变中的应用价值

目的 探讨高频超声引导下穿刺活检在小乳癌及乳腺癌前病变诊断和治疗中的临床价值.方法 对超声发现的92例乳腺小病灶,在高频超声引导下进行穿刺活检取得病理结果 ,并与手术后病理进行对照.结果 穿刺病理结果 为56例乳腺癌、7例乳腺癌前病变及29例乳腺良性病变,91例与手术后病理结果 相符,仅1例活检穿刺报告为腺病者手术后病理证实为导管内原位癌.超声引导下穿刺活检诊断乳腺癌和癌前病变的敏感性为100%,特异性为96.6%,准确性为98.9%.结论 高频超声引导下对乳腺小病灶进行穿刺活检是安全、可靠的术前早期诊断方法 .     

超声引导下乳腺小肿块穿刺活检临床价值初步探讨

目的:探讨超声引导下粗针活检对乳腺小肿块的诊断价值。方法:采用Bard可调式自动活检枪,18G切割活检针,实时彩色超声监视,每个病灶取材2～3次。结果:132例患者共70例获手术病理,其中1例穿刺失败,病理证实乳腺癌18例、叶状囊肉瘤1例、良性病变50例,超声引导下粗针活检诊断小乳腺癌的特异度和灵敏度分别为100%和89.5%。结论:超声引导下粗针活检是一种特异度和灵敏度均较高的乳腺小肿块术前诊断方法。     

负压活检枪技术在诊断乳腺占位性病变的临床应用

目的探讨应用巴德Magnum全自动负压活检枪,在彩超引导下穿刺活检,对诊断乳腺占位性病变的临床价值。方法对47例乳腺占位性病变患者应用活检枪技术在彩超引导下行病灶穿刺活检,共取组织49条,并经病理切片诊断,分析其准确率及与术后大体标本的病理诊断的符合率。结果 47例患者穿刺成功率为100%。其中乳腺纤维腺病34例,纤维腺瘤11例(假阴性1例),浸润性导管癌1例,浆细胞性乳腺炎1例。超声引导穿刺活检的病理诊断与术后病理诊断符合率为97.87%(46/47)。所有病例穿刺活检后均无并发症发生。结论应用巴德Magnum全自动负压活检枪,在彩超引导下对乳腺占位性病变进行穿刺活检,与手术切除病理诊断有很强的一致性,且安全可靠,是临床确定乳腺占位性病变性质的有效方法。 更多还原     

高频超声及彩色血流在乳腺疾病中的诊断应用

目的　讨论高频超声在乳腺疾病诊断中的价值。方法　对比分析198例乳腺肿块患者的超声及彩 色多普勒检查结果与手术后病理检查结果的诊断符合率。结果　经术后病理检查证实的乳腺癌41例,纤维腺瘤 92例,乳腺增生症52例,其它13例,提示高频彩超对恶性乳腺疾病的诊断符合率89.1%,良性疾病的诊断符合率 97%。结论　根据高频彩色多普勒血流信号可对乳腺疾病的良恶性作出鉴别,说明高频彩超在乳腺疾病诊断中有 相当大的价值。     

超声引导下粗针穿刺组织活检诊断乳腺肿瘤价值

目的观察超声引导下乳腺肿块穿刺活检的临床应用价值。方法77例拟诊乳腺癌患者,在超声引导下行粗针穿刺活检术,对取得组织行组织病理检查或免疫组织化学检查。结果患者均穿刺成功,取材满意度100％,穿刺后均未发生并发症,组织病理诊断恶性肿瘤72例,良性肿瘤5例。结论粗针穿刺组织活检操作简单、损伤小,是诊断乳腺肿块性质的有效方法之一。     

触摸不清的乳腺病灶在超声引导下的粗针穿刺活检

目的分析超声引导下对触摸不清的乳腺病灶进行穿刺活检细胞学和病理学检查的诊断准确率。 方法超声在72例女性中检出80个触摸不清的乳腺结节，在超声引导下用18G穿刺针穿刺活检。以术后病理诊断和随诊结果为标准，分析穿刺细胞学和病理组织学检查的诊断准确性。 结果穿刺细胞学诊断为良性者60个，可疑恶性者6个，有恶性细胞者14个，其中证实为恶性者分别有1个，2个和13个。敏感性为93．8％，特异性92．2％，诊断准确率92．5％；穿刺病理学诊断为良性病变者65个，恶性者15个，证实为恶性者分别有1个和15个，敏感性为93．8％，特异性100％，诊断准确率98．8％。2种方法的敏感性一致，而特异性和诊断准确率差异有统计学意义（P＜0．05）。 结论对于不能触及的乳腺结节，超声引导下乳腺粗针穿刺的细胞学和病理学检查是可靠的诊断方法，且后者更有效。     

彩色超声多普勒在乳腺触诊阴性病变微创诊断中的应用

目的彩色超声多普勒引导下用微创方法对乳腺触诊阴性的病变进行活检,良性病变完全切除,评价彩超在此微创诊疗中的应用。方法30处临床触诊阴性的乳腺病变均经超声清晰显示,疑为恶性病变7处,其中4处含微钙化,良性病变23处。30处病变均行Mammotome微创旋切术活检,整个过程彩超动态实时监测,评价其诊疗效果。结果23处良性病变完全切除,其中纤维腺瘤15处,乳腺腺病6处,非典型增生2处;疑为恶性的7处病变仅行部分切除活检,其中6处为恶性肿瘤,1处为乳腺囊性增生,疑为恶性的病灶后均经手术切除并复送病理证实。所有病例术后1周、1个月、3个月行临床及彩超复查,未发现复发迹象。结论Mammotome微创旋切术是目前诊断乳腺病变的理想方法,彩超在该微创诊疗中具有重要的作用。     

彩色超声引导下乳腺肿块穿刺活检的临床价值研究

目的探讨彩色超声引导下乳腺肿块穿刺活检的临床价值。方法采用Bard可调式自动活检枪，16G切割活检针，实时彩色超声监视，每个病灶取材2～4次。结果105例乳腺实性占位性病变，共112个病灶，80例获手术病理，怀疑恶性2例，不符1例，假阴性2例，诊断敏感性95．2％（100／105），诊断准确率达97．1％（102／105）。结论彩色超声引导下对乳腺病变进行穿刺活检，与手术切除病理诊断有很强的一致性，且副作用少，简单安全，成本低，容易被患者接受，值得临床推广使用。     

Fourteen-gauge ultrasonographically guided large-core needle biopsy of breast masses.

OBJECTIVE: Large-core needle biopsy of the breast can be performed with stereotactic or ultrasonographic guidance. However, ultrasonographically guided large-core needle biopsy has notable advantages, including the absence of ionizing radiation, increased patient comfort, and greater cost-effectiveness. The purpose of this study was to evaluate the accuracy of ultrasonographically guided large-core needle biopsy for the diagnosis of breast cancer in palpable and nonpalpable breast masses. METHODS: The study was a retrospective review of consecutive ultrasonographically guided large-core needle biopsies for indeterminate breast masses. A total 424 ultrasonographically guided core biopsies were performed in 367 patients with 1 or more breast masses. Ultrasonographically guided core biopsy was performed with a 14-gauge spring-loaded needle and a freehand technique. Correlation of ultrasonographically guided core biopsy pathologic findings with subsequent surgical pathologic findings or long-term imaging follow-up was performed. RESULTS: Of 424 indeterminate breast lesions for which histopathologic findings were obtained by ultrasonographically guided core biopsy, 234 cancers were diagnosed. Twenty-eight additional lesions had either questionable but not definitively malignant pathologic features (n = 11) or radiologic-pathologic discordance (n = 17) and were surgically excised. Of these, 8 additional cancers were diagnosed. Patients or surgeons chose excision of 41 additional lesions that were benign on ultrasonographically guided core biopsy No cancer was found in these surgical specimens. One additional cancer was diagnosed at a 6-month imaging follow-up because of interval growth. On the basis of surgical and long-term imaging follow-up, the sensitivity of ultrasonographically guided core biopsy for the diagnosis of breast carcinoma was 99.2% (95% confidence interval, 95.6%-99.9%) in 173 palpable breast masses and 93.2% (95% confidence interval, 87.1%-97%) in 251 nonpalpable masses. In cancers diagnosed on the basis of immediate surgical excision as a result of ultrasonographically guided core biopsy that showed either questionable pathologic features or radiologic-pathologic discordance, the sensitivity of ultrasonographically guided core biopsy for the diagnosis of breast cancer was 99.2%. CONCLUSIONS: Ultrasonographically guided large-core needle biopsy is a sensitive percutaneous biopsy method for the diagnosis of breast cancer in palpable and nonpalpable breast masses.     

乳房肿块的超声诊断价值

本文报告２５０例共３１７只乳房肿块的超声检查资料，所有病例均经手术和病理证实。乳腺癌诊断符合率为８１．４１％，腺瘤为８７．２５％。发现的最小良性病灶４×５ｍｍ，最小癌６×６ｍｍ。本文就乳癌的早期发现、良恶性病灶的鉴别及部分病例误诊原因分析等几方面作了讨论。作者认为高分辨率、高频探头的应用为乳腺内小病灶的发现提供了基础。肿块的边界、包膜及形态是鉴别良恶性病灶的首要标准。而彩色多普勒信号仅能在此基础上起辅助作用。对发现的不能明确其性质的病灶可在超声引导下穿刺活检。     

彩色多普勒血流显像对乳腺肿块的分析

本文通过对48例乳腺肿块的彩色多普勒血流显像(CDFI)检查,经手术和病理证实,良性肿块为21例,恶性肿瘤为27例。其结果显示:恶性肿瘤血流信号检出率为92%,良性肿块是33%,恶性肿瘤血流信号检出率明显高于良性肿块(P＜0.05)。良、恶性肿瘤之间的临界流速值为12cm/s。B型超声辅以彩色多普勒血流显像检查可以提高乳腺恶性肿瘤特别是2cm以下小乳癌的诊断率。     

Diagnostic accuracy of sonography and combined sonographic assessment and sonographically guided cytology in nonpalpable solid breast lesions

PURPOSE: The aim of this study was to assess the diagnostic accuracy of sonography alone and combined sonographic assessment and sonographically guided fine-needle aspiration cytology in solid, nonpalpable lesions of the breast. METHODS: We retrospectively evaluated the sonograms from a series of 174 consecutive nonpalpable masses that were cytologically diagnosed using fine-needle aspiration under sonographic guidance and then histologically verified through surgical excision. We examined the relationships between the findings from sonography, combined sonographic assessment and cytopathology, and histology. RESULTS: Histologically, 95 lesions (55%) were malignant and 79 (45%) were benign. The overall sensitivity of sonography alone for diagnosing cancer was 98. 9% (94 of 95 lesions), and the specificity was 45.6% (36 of 79 lesions). One (3%) of 37 masses considered at sonography to be benign was correctly diagnosed on cytologic examination to be cancer. By establishing the benign status of 11 of 13 masses that were indeterminate at sonography, cytology increased the specificity of the combined method (to 56.3%). Cytology appropriately suspected or confirmed malignancy in 79 (84%) of 94 carcinomas considered at sonography to be suspicious or malignant. CONCLUSIONS: In this study, sonography alone demonstrated a high sensitivity but limited specificity in evaluating nonpalpable breast masses. The addition of sonographically guided cytology substantially increased the specificity of the combined method without compromising sensitivity.     

彩超在乳腺癌诊断中的价值

目的　探讨乳腺癌的彩超诊断价值 ,分析误诊原因。方法　彩色多普勒对 5 2例乳腺癌患者癌肿的形态、大小、内部回声及血流动力学指标及临床资料 ,并检查有无腋窝淋巴结转移。结果　 5 2例乳腺癌中超声作出定性诊断 4 5例 ,占 86 5 4 % ;性质待定 2例 ,占 3 85 % ;误诊为良性病变 5例 ,占 9 6 2 %。结论　具有典型声像图的乳腺癌彩超诊断正确率较高 ,但对于瘤体较小而又不具有典型声像图的早期乳腺癌 ,彩超诊断比较困难 ,需结合临床表现、穿刺细胞学、乳房钼靶片等检查 ,以期达到尽早确诊 ,减少漏误诊     

彩超及频谱Doppler超声在乳腺肿块鉴别诊断中的应用

本文对６１例６８个乳腺肿块进行了彩色Ｄｏｐｐｌｅｒ血流显像（ＣＤＦＩ）及脉冲Ｄｏｐｐｌｅｒ（ＰＤ）的检测，其中乳癌２２例，良性肿块３９例，均经手术和病理证实。结果表明：ＣＤＦＩ能迅速显示乳腺肿块的血流形态和分布，ＰＤ可区分动、静脉血流，在ＣＤＦＩ引导下进行检测可避免单纯ＰＤ检测的盲目性。动脉血流在２１例乳癌和６例乳腺良性肿块中获得，而乳癌的血流阻力指数（ＲＩ）均大于０．５５．彩超及频谱（双功彩色）Ｄｏｐｐｌｅｒ超声诊断乳腺肿块的总符合率可达９７．１％，高于灰阶超声诊断。因此，Ｄｏｐｐｌｅｒ超声对乳腺肿块性质的判断是有价值的。     

超声诊断乳腺肿块的临床价值及钼靶对照分析

目的：评估超声对乳腺肿块的诊断价值。方法：对71例乳腺肿块患者进行超声及钼靶检查,并分别与病理对照。结果：良恶性乳腺肿块的声像图有明显差异。超声对良恶性乳腺肿块的诊断正确率分别为91.3%,84.0%。钼靶为58.7%,72.0%。结论：二维彩色多普勒超声对乳腺肿块的诊断具有优势。