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The value of high frequency color Doppler in diagnosis of breast mass

Author: QinShaoRong From: www.yourpaper.net Posted: 2009-06-14 03:26:39 Read:
Keywords thesis: high-frequency color Doppler ultrasound; breast masses; ultrasound diagnosis of

Abstract: Objective: To investigate the
high frequency color Doppler (CDFI) ultrasonography (ultrasound) in the diagnosis of breast masses.Methods: a retrospective analysis of 85 cases in our hospital in 98 by high frequency ultrasound and breast masses confirmed by operation, pathology.Results: compared with high frequency ultrasound in 85 cases of breast masses with the postoperative pathological results, the diagnostic accuracy rate of ultrasound was 85.9%, specificity 92.2%, sensitivity 55.3%.Conclusion: high frequency color Doppler ultrasound in breast masses in the examination, can directly or indirectly reveal the structure of the masses, benign and malignant primary diagnosis.Is a simple and effective method for the diagnosis of breast masses.



With the application of high frequency color Doppler ultrasound, breast tumor detection rate is higher and higher, a lot of local breast examination has been listed as the health examination program. And the distinction between benign and malignant tumors and is a severe problem in ultrasound doctors.The author of the 85 cases of breast tumor patients with color Doppler ultrasound examination results retrospectively analyzed as follows.

Materials and methods
1

1.1 average data
The author collected from 2001 January to 2006 January in our hospital, 85 cases of breast masses were treated, aged 19 to 64 years old, average 42 years old, all female patients, underwent high frequency ultrasound.All the cases in the ultrasound examination in 3 ~ 7d after treated by operation of parallel inspection pathology, including 55 cases of benign tumors, 30 cases of malignant tumor, the largest tumor 58mm 47mm, 8mm 7mm minimum, a total of 98 nodules.

Methods 1.2
The instruments for the Hitachi EUB-6000 color ultrasound diagnostic apparatus, the frequency of 7.5 ~ 10MHz broadband high frequency probe.Patients were supine position, fully exposed bilateral breast, the nipple as the center, check the breast in order to sweep from 1 to 12 radial multiple views.Firstly, bilateral breast were examined by B ultrasound mode, observation of breast thickness, internal echo, boundary, tumor size, shape, nature of activity level. Then enabled color Doppler blood flow, observation, breast mass and resistance index, blood flow velocity and so on, the last regular scan bilateral axillary lymph nodes metastasis.Check at the same time, enable the ultrasound workstation, mining graph, calculation and analysis in diagnosis of suspicious lesions.

1.3 ultrasound of breast masses
Mainly includes the shape, boundary mass, internal echo and calcification, masses echo back, lateral shadow, aspect ratio, axillary lymph node, activity of the masses, the blood supply and the artery frequency spectrum.Difference between benign and malignant tumors, as follows: the differentiation of
The features of two-dimensional ultrasound malignant: mass boundary is not clear or burr, appearance is irregular or lobulated, crab-like, internal echo uneven, partial masses visible tiny calcification spots, tumor tissue adhesion and poor activity, anteroposterior diameter greater than the transverse diameter, the rear echo attenuation was.Color Doppler: mass flow is abundant, grade signal of blood flow, mass flow in high speed and high resistance pattern of blood flow signal.
The features of two-dimensional ultrasonography in benign tumor boundary is clear: the echo envelope, regular shape is oval, diameter greater than the anteroposterior diameter, internal echo is uniform, mass activity, organization and the superficial and deep structures of demarcation is clear.Color Doppler: the inside of the masses visible strip flow signal, to nature, to the low resistance of blood flow signal.

1.4 statistical processing of
All data are used SPSS 11 statistical software for statistical analysis.The operation pathology results as the gold standard for diagnosis, were calculated for high frequency ultrasonographic diagnosis of breast malignant lesions of the sensitivity, specificity and accuracy.

The results of 2

2.1 pathological examination and
85 cases of 98 tumor nodules by high-frequency ultrasound detection, the detection rate of 100%, which were single in 55 cases, 30 cases of multiple.The 98 breast masses all operation treatment, the results of pathological examination: benign group and 55 cases in 68 masses, including breast cyst of breast fibroadenoma 17 nodules, 40 nodules, 6 nodules of breast intraductal papilloma, fibrocystic disease of breast 3 nodules, 2 nodules of mastitis.The malignant tumor group, 30 cases with 30 nodular masses, 19 nodules with infiltrating ductal carcinoma, ductal carcinoma in situ of 5 nodules, 4 medullary carcinomas mucinous adenocarcinoma nodules, 2 nodules.

2.2 breast cancer ultrasound image mainly
In breast masses have characteristics, two-dimensional ultrasound typical increased, mass in the blood flow in high speed and high resistance flow spectrum and mass inside the tip sample clusters of calcified plaque.The blood tumor: Blood Malignancy Tumor: 0 vessels in 2 cases accounted for 6.7%, I vessels in 4 cases accounted for 13.3%, grade II vessels in 8 cases accounted for 26.7%, og class vessels in 16 cases accounted for 53.3%; benign tumor blood supply: 0 vessels in 20 cases accounted for 36.4%, I vessels in 34 cases accounted for 61.8%, class I vessels in 1 cases accounted for 1.8%, no I level of patients with vascular.The pulse Doppler (Pw) measurement of mass flow: the maximum velocity of malignancy tumor artery systolic (PSV) > 20cm / s in 24 cases of benign tumor artery accounted for 80%, group PSV was less than 15cm / S; vascular resistance index of malignant tumor group (RI > 0.7); in 27 cases accounted for 90%, benign group mass RI were less than 0.7.
Two-dimensional ultrasonography: malignant masses in the tip sample clustered calcification in 23 cases accounted for 76.7%, 6 cases of benign masses only patchy calcification, no tip sample clusters of calcified plaque. axillary lymph node enlargement, benign group except 2 cases of mastitis patients with axillary lymph node enlargement, other cases no axillary lymph node enlargement.While the malignant group had 23 cases of axillary lymph nodes accounted for 76.7%.Activity of the tumor, malignant 26 cases in group activities of the poor, and only 8 cases of benign group activities.

2.3 high frequency color Doppler ultrasound diagnosis of
Benign group of ultrasound diagnosis of 47 cases were benign, 8 cases were misdiagnosed as malignant tumor; ultrasound diagnosis was malignant in 26 cases, 4 cases were misdiagnosed as benign.The sensitivity was 55.3% in the group of patients with ultrasonic diagnosis (26 / 47), the specificity was 92.2% (47 / 51), the accuracy rate was 85.9% (73 / 85).

3

Method for the diagnosis of breast diseases
3.1
Palpation, X-ray, infrared, angiography, MRI examination has certain limitations, only the high frequency ultrasound image is clear, high accuracy, low cost, no wound and no side effects, can be repeated examination.

Growth, development and metastasis in 3.2 tumors are dependent on arterial blood
The process of angiogenesis in physiological and pathological, the morphology and distribution of angiogenesis induced by regulation, agent and inhibitor, both under physiological conditions in a dynamic balance, tumor angiogenesis is affected by a variety of vascular factors regulating _1].Because the antiangiogenic agent malignant tumor secretion increased, increased, tumor vascular morphological diversity, kink into the net, irregular distribution, vascular resistance index was significantly higher than in benign tumor.It is reported, the resistance index (R1) 0.70 critical values for the identification of breast tumor.In this group of cases of malignant group 30 cases in 27 patients showed high resistance flow signal, the RI value is greater than 0.70.Application of CDFI for detection of tumor blood flow, can be used as an important basis for the diagnosis of benign and malignant tumors.The richness of vascular lesions in divided into four grades: grade 0, no blood flow signal within the lesion; I, a small amount of blood flow, 1 ~ 2 visible spot blood flow; I, in the amount of blood flow, the 1 main blood vessels, the length of more than mass radius or see a few small blood vessels; I rich, blood vessels, so more than 4 vessels, or vessels crossing into mesh.Benign tumor is usually I flow, I flow in malignant tumors were.

3.3 tumor calcification is the differential diagnosis of benign and malignant tumor is another important index of
In the high frequency sonographic calcification can be divided into three types: micro calcification, tip sample with a cluster of strong echo of point is less than 1mm, posterior acoustic shadowing.The coarse calcification, greater than 1mm strong echo point with acoustic shadow behind.The arc arc or ring calcification, strong echo mass surface or interior, with acoustic shadow behind.Calcification of breast cancer detection rate is higher, and more features, typical calcification of breast carcinoma with a cluster distribution, the number and relative concentration, a sandy calcification.Calcification of breast fibroadenoma less number of typical, diameter more than 1mm, a coarse calcification or annular calcification.


3.4 lymph nodes
Lymph node metastasis is a complication of the most common malignant tumor, malignant breast tumor lymph node metastasis, mainly for axillary lymph node enlargement, with short diameter increased significantly, lymph node diameter and short diameter
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