摘要
目的通过对乳腺癌超声诊断中假阴性及假阳性病例的图像进行分析,探讨超声漏误诊的原因。方法经超声检查并有手术病理资料的乳腺肿块中140例声像图难以确认其良恶性,对照其病理结果进行分析。结果乳腺癌超声诊断假阴性95例,假阳性45例。假阴性病例的恶性征象多数存在图像的交叉重叠,假阳性病例形态边缘类似恶性图像特征(包括不规则、小分叶、毛刺表现)显示率高与其他征象,差异有统计学意义(P<0.05)。假阴性病例血流信号检出率为49.5%(47/95),假阳性病例血流信号检出率为66.7%(30/45)。假阴性病例血流分布比较差异有统计学意义(P<0.05),假阳性病例血流分布比较差异无统计学意义(P>0.05)。假阴性和假阳性病例肿块大小分布不同,差异均有统计学意义(P<0.05);假阴性和假阳性病例乳腺质地分布比较,差异均无统计学意义(P>0.05)。结论特殊的病理类型、病灶小、呈周边型血供或无血流是导致乳腺癌超声漏诊的主要原因;病灶结构复杂多样、血供丰富或淋巴结肿大是导致乳腺良性病灶超声误诊为恶性的主要原因。
Objective To explore the reasons of ultrasound missed and misdiagnosis by analyzing false - negative and false - positive cases in ultrasound images of breast cancer. Methods 140 sonogTams of breast lumps with pathological data were difficult to judge benign or malignant. Comparative analysis was performed by using sonograms and pathological findings. Results In the diagnosis of breast cancer by ultrasound, 95 cases were false - negative and 45 cases were false - positive. Most images of the malignant signs of false - negative cases were overlapping, while false - positive cases had high show rate of malignant imaging characteristics （irregularity, small segment and burr） （P 〈 0.05 ） . Detection rate of blood flow signal in false -negative cases was 49. 5 % （ 47/95 ）, while the detection rate of blood flow signal in false - positive cases was 66. 7% （30/45） . There was sta- tistically significant difference in blood flow distribution among false - negative cases （ P 〈 0.05 ）, while there was no statistically significant difference among false - positive cases （ P 〉 0. 05 ） . The distribution of false - negative cases and false - positive cases when tumor sizes were different showed statistically significant difference （ P 〈 0. 05 ） . The distribution of false - negative cases and false - positive cases when breast texture was different showed no statistically significant difference （ P 〉 0. 05 ） . Conclusion Special pathological type, small lesion, showing peripheral blood supply and no blood flow are main causes for missed diagno- sis of breast cancer by ultrasound. Complicated lesion structures, enriched blood supply and lymph nodes enlargement are main causes for benign breast cancer misdiagnosed as malignant.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第24期2735-2738,共4页
Chinese General Practice
关键词
乳腺肿瘤
超声检查
误诊
Breast neoplasms
Ultrasonography
Misdiagnosed
