Ultrasonic characteristic of mammary gland soaking conduit cancer

Abstract. Analyze mammary gland soaking conduit cancer (IDC) in purpose Audiovideo picture characteristic, last diagnosis value of supersound vs. IDC. The method analyzes 30 IDC two-dimentional picture characteristic and energy Doppler's blood flow shape, spectral parameter verified by pathology. As a result reveal in 30 burr soliciting or crab's foot solicits 14, peripheral high echo lets 10 faint, 16 cases of internal little calcification, echo decays by 15 at the rear; Doppler reveals energy without 1 case of blood flow, 29 cases of point-like or short linear blood flow of the star, it is 17, 14, 14 cases to wear the human-like, branch, not regular blood flow respectively. The internal blood flow of 25 lumps is shown as the high hindering type of the high speed (Ps is greater than or equal to 17 cm/ s, RI is greater than or equal to 0. 7). 21 have axillary enlargement of lymph nodes. There is the manifestation of its characteristic nature in the audio video picture in the conclusion IDC, the supersound can become and diagnose that study one of the methods in effective image of IDC.

Key words:Breast; Conduit cancer; Ultrasonic inspection

1.Introduction

One that mammary gland soaking conduit cancer is seen at most by various breast cancer, account for the total number of breast cancer 50% - 80% . This text analyzes two-dimentional audio video picture characteristic and energy Doppler's blood flow of 56 IDC verified by operation pathologies are distributed in the way, aim at raising the ultrasonic accuracy rate of diagnosis of IDC.

2.A materials and method

A materials and method

A research object collects and proves mammary gland soaking conduit cancer (infiltrative ductal carcinoma from the pathology after performing the operation of June of one 2004 of September of 2003, IDC) 30 patients, is women, 26-89 years old, average 48. 2 years old. Main clinical manifestation, for mammary gland can be touchedding 31 cases of left milk lumps, 25 cases of right milk; 15 quadrants on outside among them.

instruments and methods

Adopting Germany SIEMENS SONOLINE 0mina supersound apparently looks like the appearance, 7. 5- Smallpart software of popping one's head of burst of 13 MHz wide-band line. Patient lie supine location, put up at the both arms, expose pairs of the intersection of side and breast fully, take the form of radiatiform, sweep checking in 4 the intersection of quadrant and large tangent plane with nipple for centre, regular ascertains one pair of sides armpit. Observe and record lump and take place on position, shape, edge, internal echo, whether there is calcification, have side sound shadow and dual sides axillary lymph node swelling. Superpose colored in the intersection of lump and position, observe the intersection of blood flow and signal, rich in intensity, grade according to Aderler half quantification law: O grade does not have blood flow, I grade is the point-like, short bar-shaped blood flow, ｊ grade is 1- 2 blood vessels on a section,grade or fill the netted blood flow [1 ] of the form for more than 3 blood vessels.

3.RESULT

Divided into 4 types 30 soaking conduit cancer patients according to the ultrasonic audiovideo characteristic, I type is the irregular substantive lump type of the shape, 19, shown as the low echo or mixing echo without membrane of bag charters the piece, shape abnormality, the edge is burr disease or crab's foot. Among them 10 can be seen little calcification. The blood supports the situation: 3 cases of o grade, 3 cases of I grade, 8 cases of ￠ò grade, one grade of 5. ￠òType show as bag mixings real echo make piece, 4, find the piece medical history of the bag relatively long, in 4- 6, were shown as the real mixing echo of the round bag charters the piece, clear in the border, take bag as the core, real some shape abnormality, the edge is burr disease or crab's foot, the blood supports the situation: ￠òGrade of 2, one grade of 2.Type expand companion to lumps substantive conduit,3 cases, be shown as whether the milks be expanded to be in charge ofed for the fainting areas milk, carry far and can be seen the low echo and wrap up the piece, shape abnormality, is crab's feet and burr diseases, the blood supports the situation: ￠òGrade of 2, grade is one.Type rule is substantive of shape lump,4 case, show as whether there aren't echoes low, clear in the border, there is a side sound shadow, the blood supports the situation: 3 cases of O grade, 1 case of I grade. 2 0 cases of visible enlargement of lymph nodes in 3 O example, 11 among them have lymph nodes to shift.

4.DISCUSSED

IDC is a basic type of breast cancer, take all breast cancer 60% - 80% , Tie the cancer cell and pierce through the conduit basilar membrane and invade a quality and different from benign tumour on pathology, there is supersound of its characteristic that behaves. Summarize the image of IDC and learn to behave, The level that can improve the supersound and diagnose breast cancer, diagnose clinic as soon as possible and determine the healing solution has important meanings. The high-frequency supersound finds one of the important inspection methods of breast cancer in early days, not only can find lump in early days, can also be used for distinguishing tumour is good and m alignant. Mammary gland soaking conduit cancer is that the cancer cell pierces through the basilar membrane of conduits or gland bubbles and invades a quality, form, harden in mammary gland, early to soak to surrounding tissue, form " the the intersection of crab and the intersection of foot and kind " at the ultrasonic the intersection of audiovideo and picture Or " burr kind "Characteristic behavior. Soaking conduit cancer is that skin cells are developed on the cover or first type small leaf from different conduit cancer. Development of it can with

The lapse of time changes, is developed into soaking conduit cancer by not soaking conduit cancer. Type and type last the development course supersound of soaking conduit cancer.

Figure 1 smooth conduit pipe cancer burr edge syndrome

Figure 2 Smooth conduit pipe cancer edge hyperechoic halo and internal microcalcifications, posterior echo attenuation

Figure 2Tube carcinoma within a branching flow signal, Ps to 58.8 cm / s, RI reached 0.91

There is 4 example lump clear border in this research, shape rule, there are side sound shadows, it is more difficult to distinguish with benign tumour. To this kind of patient, should observe the lump perimeter carefully, can see the slighter small projection. Combine patient's age at the same time, the mammary gland charters the piece palpation texture, very movable and axillary lymph node is swelling,etc. to make diagnosis. Lump edge burr solicit and the intersection of crab and foot solicit lump edge burr solicit and the intersection of crab and foot it solicits to be the intersection of conduit and cancer of soaking etc. supersound of characteristic display mouth most, its pathologic foundation results from soaking the surrounding tissue in tumour, the supersound displays edge thickness of lump, burr different in size or crab's low echo of foot. The burr of IDC is often spreading and taking the form of crab's foot in every direction from the lump centre of tumour, his nearly tumour body ends are slightly thick, attenuate gradually from the close-by examples to those far off. In example lump of this group, 60. 7% (34/ 56) With the burr. The burr size can also be cancerous swelling the judgement of soaking the range is offered the basis. The high echo faints there is 53 in this group around. 6% (30/ 56) Faint to surround echo of the one irregular is high around lumping,it is generally acknowledged whether cancer cell last conduit to among quality be caused connective tissue not to be reacted to be soaked, inflammation is oozed out or organize edema and blood vessel new student and form the smudgy infiltration of border and mix and take the heart, shown as the high echo of the tumour perimeter faints in the ultrasonic picture. Intra-annular lump can be a burr to faint, assign to foliate, round,etc..

There are invariable relations to think breast carcinoma and necrosis and m alignant intensity on a little calcification pathology, m alignant intensity high, the intersection of necrosis and the more obvious; When necrosis happen in the cancer cell, apt to cause calcium salt calmly, so the higher the m alignant intensity of breast carcinoma is, the higher the incidence of the little calcification is. IDC is shown as lump of low echo, has provided the good display background for detection of the little calcification too in the supersound, this group is up to 69. 6% (39/ 56) The detection rate of little calcification keeps the same with a lot of scholars' research.3. 4 the intersection of rear and echo lower, think lump the intersection of rear and echo it lowers to be because cancer the intersection of quality and content higher than essence organize, more at present, the absorption that can cause sound decays. This group of frequency is 62. 5%, is lower than 64% such as Skaane slightly. 3. 5 Doppler's supersound Doppler supersound can reveal the diameter is greater than the tumour blood vessel of 200um, especially because energy Doppler is not that the angle dependence and high sensitivity reveal vascular continuity is good, can reveal more intact blood vessel network and blood vessel tree, reveal to small blood vessel, tip blood flow and Yu song blood vessel the result is especially obvious. And morphology with vascular tumour is considered to be the most specific change of m alignant tumour, so energy Doppler has great advantages in the morphological research with vascular tumour. This group 98. See blood flow signal in 2% of the lumps, penetrating type, branch and not regular blood flow are mostly signs of m alignant tumour. There is more for the high hindering type of the high speed blood flow in m alignant tumour, this group chooses at present the spectral parameter index Ps which most scholars relatively approve is greater than or equal to 17 cm/ s, RI is greater than or equal to 0. 7,These two indexes have higher sensitiveness and specificity, the coincidence rate of this group is 86%. This group 60. Can see branch's blood flow in 7% of the lumps, branch's blood flow is from backbone to tip, the velocity of flow decreases progressively step by step, resistance is increased progressively step by step, this is because tumour nourishes the blood vessel and comes from host's blood vessel, the velocity of flow high, his subordinate's branch plays a role in shunting to the blood flow of the main tributary, so measuring the velocity of flow of maximum peak value had better be chosen at the place where most close to the initial department of blood vessel in tumour; And nearly tip,it if it is easy that if you can't shorten into, if you can't divide, lack deformity on tumour is vascular such as, cancer bolt, narrow and blocking,etc. the less obvious, resistance increase mouth thereupon too, so measurement most big RI you had better choose in the intersection of blood vessel and tip portion. Can than measure in the lump most Ps and RI more fast while being accurate in this way.

Confirm axillary to have lymph node shift to tumour by stages in front of the 6 skill, the choice, estimation of prognosis and formulation of auxiliary healing solution of the surgery way have important clinical value. Axillary ultrasonic imaging, to confirming it is an extremely effective simple and convenient method whether the lymph node is shifted. The lymph node of metastasis of cancer changes because of pathologic institutional framework if the lymph node cancer cell disperse is distributed, make the structure, level of the original normal lymph node totally disappear, the audiovideo chart is lymphadenovaris now, shape show in round or not oval, edge still smooth, than even unanimous low echo inside, lymphocytic pieces of structure disappear, there can be more abundant blood flow signals in inside. It is that the axillary lymph node of breast carcinoma shifts the more specific picture that the lymph nodes of occuring frequently and integration state are swelling. Have 5 example leak, examine in the group this, might shift lymph node to be too light, supersound difficult to reveal or operate cause not so careful while being clear.

The supersound of this group is misdiagnosed for 3 benign lumps, this 3 are shown as diameter small 2 cm, shape rule, clear low echo lump of border, internal echo distribute even, have little calcification, rear strengthen, internal blood flow abundant. As to smaller IDC, difficult and benign lump is distinguished on the audiovideo picture, how to distinguish the two are the directions of ultrasonic efforts at present. As to above the age of 35, it is relatively hard to wrap up the piece texture the mammary gland, it is poor to move degree, patient of the axillary enlargement of lymph nodes, can't make the diagnosis of benign tumour easily, so as not to delay making a diagnosis and giving treatment.

References

[1]Xin Hua, puts in the country, Liang Bo,etc.. The supersound of mammary gland soaking conduit cancer is diagnosed [J ]. Study the magazine in China's ultrasonic image, 2006, 15(1) : 72-73.

[2]Seidman MD, Lauren LA, Aisner SC, et a1. Relationship of the size of the invasive component of the primary breast carcimoma to axillary lymph mode metastasis[J]. Cancer, 1995, 75(1) : 65-71.

[3]Tavassoli FA. Pathology of advanced primary breast carcinoma [J]. Surg Oneol Clin N Am, 1995, 4(4) : 591-600.

[4]Kan X Clinical pathology of breast cancer[M]. Beijing: The United Publishing Company of Beijing Medical University and The Consonancy Medical University of China, 1993. 143-146.