多模态超声诊断乳腺腺病研究进展

王爽　朴艺兰

[关键词] 乳腺腺病;乳腺癌;超声检查;鉴别诊断

[中图分类号] R737.9           [文献标识码] B          [文章编號] 1673-9701（2021）17-0189-04

Research progress of multimodal ultrasound diagnosis of breast diseases

WANG Shuang1， 2   PIAO Yilan1， 2

1.Department of Ultrasound Medicine， Affiliated Hospital of Yanbian University， Yanji   133000， China; 2.Yanbian University， Yanji   133000， China

[Abstract] In recent years， the incidence of breast disease ranks first in breast disease， and it is the most common benign breast disease in women. Among them， Breast sclerosing adenosis is easily confused with breast cancer， so early differential diagnosis has positive clinical significance for patients' follow-up treatment. Conventional ultrasound is the basis for the diagnosis of breast disease. With the rapid development of ultrasound technology， the application of contrast-enhanced ultrasound， elastography， and automatic full-volume breast imaging has further improved the accuracy of the diagnosis of this disease. Therefore， this article has compiled relevant literature in recent years， summarized and analyzed the characteristics and manifestations of different types of breast disease and breast cancer， in order to improve the level of discrimination and to provide a certain theoretical reference for the clinical differential diagnosis of breast disease and breast cancer.

[Key words] Breast disease; Breast cancer; Ultrasonography; Differential diagnosis

乳腺腺病（breast adenosis）是指乳腺小叶内末梢导管或腺泡数目增多，后期渐有间质纤维组织明显增生而形成的一种良性增生性病变。该病好发于中青年未绝经期女性，发病原因目前尚无明确说法，多认为与内分泌水平有关，一般表现为雌激素过高、孕激素减低或二者比例失调[1]，最终引起乳腺腺病。

乳腺腺病的发生是一个连续的过程，依其不同发展阶段及病灶组织形态，大致可分为两型：早期呈腺泡型腺病，表现为小叶内末梢导管数目增多，间质结缔组织增生，小叶融合;随小叶内间质结缔组织进一步增生，逐渐进展为硬化型腺病（Sclerosing Adenosis，SA）[1]，SA是一个组织学相对复杂的实体，包括扩大扭曲的小叶、增殖的肌上皮细胞、拥挤的腺泡和明显的间质纤维化等[2]。Ogura等[3]学者认为，SA本身是乳腺癌的一个独立危险因素，其病理及影像学表现容易与乳腺癌（尤其是浸润性导管癌）相混淆，发展成实性或筛状。因此，本文针对乳腺腺病在不同类型超声检查中与乳腺癌的相似及区别点做一综述，旨在更好地指导临床。

1 乳腺腺病超声诊断现状及特点

超声是目前诊断乳腺腺病的重要手段，因其无痛、无创、无辐射的优势受到广大患者的青睐。超声检查依其振幅的回射程度，即灰度等级进行判断，能够将肿块的解剖层次清晰显示出来[4]。各种超声诊断技术各有其优势，传统二维超声……