Diagnostic Study Of Color Doppler Ultrasonography In Mammary Carcinoma

Nowadays, the incidence rate of mammary carcinoma is increasing yearby year in our country, which has already become the first place of the femalecarcinoma in parts of the cities, with an intendancy of being youth. So earlydiscovery and diagnosis of the mammary carcinoma is very important, and hasbecomes the key point of treating effect and prognosis. The mammarycarcinoma is a broad concept, but the genuine mammary carcinoma includesonly invasive carcinoma. This study include invasive ductal carcinoma(IDC),ductal carcinoma in situ(DCIS)and microinvasive ductal carcinoma(MIDC).The mammary carcinoma pathogenic reason is undefined;it may haverelation to menses, hyperplasia mammary glands, weight, familial aggregation,hormone, medicine, food, and the spirit factors etc.The X-ray photograph has been a primary method of census anddiagnosis for the mammary cancer, but as to the young and the people ofcompact breast glands it is not that satisfactory, and is radioactive and lack ofreproducibility. Although the history of ultrasonic diagnosis is not so long, thedevelopment is fast, and having been one of the main means of diagnosticmammary carcinoma according to its self-superiority in the field.The mammary carcinoma patients having no obvious symptoms in earlystage, so it is difficult to detect the small cancer or mammary carcinoma withno significant tumor. The colorful Doppler with high frequency transducer toexamine the mammary carcinoma patients was administered in this research.Firstly, apply the two-dimensional imaging to obtain the tumor's number,distributing, position, size, sonographic features, relation to the surroundingorganizes, and make sure whether the same side armpit lymphatic gland wasthe metastasis tumours etc. Secondly, apply the CDFI and CDE to examinemammary tumors about the blood flow and distribution. Finally, compare withthe result of pathological diagnosis, outline the sonographic characters, discussthe relationship between the sonographic features and the pathology andhistological of the mammary carcinoma.If we grasp the characteristics of mammary carcinoma Image and observethe tumor carefully, we can avoid misdiagnosis and omit, improve theultrasonic diagnostic accuracy rate of mammary carcinoma, and attain thepurpose of diagnosis of the earlier mammary carcinoma patients.Material and method1. Research objectThe study's object is 45 mammary carcinoma cases (60 masses)confirmed by our hospital Ultrasonography and pathology diagnosispreoperatively.2. Instrument and methodAll subjects were detected by GE Vivid 7 Ultrasonographic machine with12MHz transducer. The patients lie on the bed, plenty uncover the breast andarmpit, adopt the direct method, take the papillae as the center in order to carryon the radiate form and over lap examination, the two sides contrasted andobserve completely including the papillae, areola mamma and armpit,particularly take notice of the papillae depth and gland edge part.Sweep the focus of infections after carefully examination, Choose thepre-established mammary condition generally, adjust the depth, gain, focus,sound beam and an angle ﹤60° between the blood stream and the bloodaccording to the concrete circumstance, aim to obtain the best picture.3. Observe contents include:(1) Mammary carcinoma of the number, distribute, the position, size,shape, boundary, internal echoes, posterior echoes, and the relationship withthe surroundings organizes etc.(2) The degree of tumor blood, and the characteristic distributes.(3) To make sure whether the lymphatic gland of same side armpit istumid, and the condition of number, size, appearance, the internal echoes flow,and differential diagnosis and to identify of it was the metastasis tumours。4. Record the result, do the ultrasound diagnostic and compare withpathologic result.5. Compute the covariance the statistics index, count date doesChi-square test.Result and discussion1) The high incidence of the mammary carcinoma ranges from 40 to 49,The familiar pathologic type is IDC(invasive ductal carcinoma).And the largerproportion of T1, T2 in the clinic stages.2) 60 mammary carcinomas were confirmed by operation and pathologydiagnosis, they most locate in the single side breast out and up side quadrant.part of mammary carcinoma are less then 2 centimeter, size 0.4×0.4~5.9×5.9centimeter, and some of the mammary carcinoma infiltrate the muscles ofchest, metastasis tumours of the same side armpit lymphatic gland ultrasonicdiagnostic coincidence rate is 52.2%.3) We have acquired the typical characteristic of mammary carcinomatwo-dimensional ultrasonic imaging, include: irregular shape, microlobulation,spiculated margin, acoustic halo, posterior attenuation, microcalcification,ductal distortion, ductal distend, aspect ratio more than 1,low level echo etc.The typical characteristic of mammary carcinoma Colour Doppler FlowImaging, include: abundant blood flow, irregular shape blood flow, peripheralblood flow, blood flow rip into tumor. The majority of mammary carcinomahas typical characteristic ultrasonic imaging, the diagnostic accuracy rate ofmammary carcinoma preoperatively reached 91.67% in this study.4) About mammary carcinoma microcalcification is a very importantcharacteristic imaging of malignant tumor with higher specificity, familiar befind in ductal carcinoma. In this study microcalcification check rate 28.3%;Spiculated margin, acoustic halo, posterior attenuation, is the typicalcharacteristic ultrasonic imaging of invasive carcinoma;ductal distend is notdiagnosis of malignant tumor of specificity index sign;Ductal distortion isdirect imaging of tumor growth, associated with DCIS and MIDC;Aspectratio more than 1, a part of tumor size affected by posterior attenuation, couldnot be measured accurately, besides associated with pressed probe degree,selected measurement section factor etc.Mammary carcinoma ultrasonic Imaging features were closely connectedwith its histology type, and can be regarded as a predictor of the histologicaltype. IDC Sonographic features of higher Yourdon's index: irregular shape,posterior attenuation, acoustic halo, spiculated margin, microlobulation,microcalcification;DCIS Sonographic features of higher Yourdon's index: lowlevel echo, ductal distortion, ductal distend, aspect ratio more than 1;MIDCSonographic features of higher Yourdon's index: ductal distortion,microcalcification, low level echo. The diagnostic accuracy rate of everyhistology type mammary carcinoma didn't identical in Ultrasonography. Thediagnostic accuracy rate was significant difference between IDC andDCIS,IDC was higher than DCIS;The diagnostic accuracy rate was significantdifference compared MIDC with IDC and DCIS, spiculated margin, acoustichalo, posterior attenuation, was inclined to IDC;ductal distortion was inclinedto MIDC, DCIS;no explicit lump was inclined to MIDC;irregular shape,aspect ratio more than 1 was inclined to IDC, DCIS;low level echo,microcalcification was clear that in various pathology type of ductalcarcinoma.5) Colour Doppler Flow Imaging detection of tumor blood vessel andblood flow, could reflect tumor blood supply circumstance indirectly. Tumorwith the ability to form abundant blood vessel net, one hand is relation totheinfiltrative growth, On the other hand it increases the metastasis ofopportunity.A majority of Tumor has more abundant blood flow signals,compared with its surrounded normal tissues, but what emphases lies in theobservation of the blood shape, anomaly, abundant blood, periphery blood,ripped into blood. In this study, some mammary carcinoma were not checkedby the blood flow signals, plus its overlap of blood flow between the benignand malignant tumor .so breast carcinoma of ultrasonic diagnosis still is ofdependence in two-dimensional ultrasonic imaging, Colour Doppler FlowImaging only acted as a complement to two-dimensional ultrasonic imaging.6) Two-dimensional imaging is typical of the smallest mammarycarcinoma as same as the mammary carcinoma;the small mammarycarcinoma preoperatively diagnostic accuracy rate is 80.8%. A minority ofsmall mammary carcinoma has no typical characteristic two-dimensionalultrasonic imaging, It is very easy to make the fake negative result.5 masseswere misdiagnosed probably benign, caused by benign and malignant tumorultrasonic imaging exist superposition, understanding shortage short ofidentify ultrasonic imaging, and the inspectors′lack of diagnostic experience,2invasive ductal carcinoma were rounded or lobular shape masses have noinfiltrative ultrasonic imaging: Speculated margin, acoustic halo, posteriorattenuation, and have no microcalcification of specificity imaging, ductaldistortion etc.;1 microinvasive carcinoma. And 2 DCIS case have no explicitlump, ultrasonic imaging low level echo, ductal distortion, 1 massmicrocalcification, 1 mass aspect ratio more than 1.All in all, ultrasonography has feasibility and practicability in mammarycarcinoma diagnosis. Mammary carcinoma ultrasonic Imaging featuresconnect with its histology type. ultrasonography not only examine the mass ofmorphological but also can judge the benign and malignant tumor in somespace.