乳腺癌切除术后创伤性神经瘤的超声表现
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南京医科大学附属无锡市人民医院超声医学科

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Ultrasonic manifestations of traumatic neuroma after mastectomy for breast cancer
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1.Department of Ultrasound,Wuxi People,s Hospital Affiliated to Nanjing Medical University,Wuxi,214023;2.CHINA

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    摘要:

    目的 探讨乳腺癌患者乳房切除术后创伤性神经瘤的超声声像图特征,以提高对该病的认识。方法 回顾性分析9例乳腺癌切除术后创伤性神经瘤患者的临床及超声声像图,根据BI-RADS词典评估病灶的位置、数目、大小、形态、边界、内部回声、内部血供情况、其与周围神经的关系和部分病灶的弹性成像评分。结果 9例乳腺癌术后患者共10个病灶,均在疤痕附近的胸大肌肌层内,纵径大小4.5~15.5 mm,平均(8.1±2.2)mm,横径大小2.8~5.9mm,平均(3.7±1.1)mm。10个病灶中,7个呈椭圆形、3个呈类圆形;8个边界清晰,余2个边界不清晰。10个病灶均为不均质低回声;8个病灶长轴与皮肤方向平行,2个病灶显示与皮肤方向不平行。在彩色多普勒检查中,5个病灶内可探及点状彩色血流信号。7个病灶可清晰显示与周围神经相连。对4个病灶进行弹性成像评分,1个为2分、3个为4分。最终6个病灶被评估为BI-RADS 4A、4个为BI-RADS 4B。结论 乳腺癌患者乳房切除术后创伤性神经瘤的超声特征是肿块位于胸大肌肌层、椭圆形、边界清晰、和皮肤平行的低回声结节,部分可清晰显示与神经纤维相连,并在弹性成像中表现为质硬肿块。

    Abstract:

    Objective To investigate the ultrasonographic features of traumatic neuroma after mastectomy in breast cancer patients, so as to improve the cognition level of the disease. Methods The clinical and ultrasonic images of 9 patients with traumatic neuroma after mastectomy were analyzed retrospectively. According to the BI-RADS dictionary, the location, number, size, shape, boundary, internal echo, internal blood supply, the relationship with the peripheral nerve, and the elastic imaging score of some lesions were evaluated. Results There were 10 lesions in 9 cases of breast cancer, all in the muscle layer of the pectoralis major muscle near the scar, the size of the longitudinal diameter was 4.5 ~ 15.5 mm, the average (8.1 ± 2.2) mm, the diameter of the transverse diameter from 2.8 to 5.9mm, and the average (3.7 ± 1.1) mm. Of the 10 lesions, 7 were oval, 3 were round, 8 were with defined margins, and the other 2 were with poorly defined margins. The 10 lesions were heterogeneous hypoechoic, 8 lesions were parallel to the skin axis and 2 lesions were not parallel to the skin direction. In color Doppler examination, punctate color blood flow signals can be detected in 5 lesions. 7 lesions could be clearly shown to be connected to the peripheral nerves. The elastography score of 4 lesions was 1 lesion 2 points and 3 lesions 4 points. The final 6 lesions were evaluated as BI-RADS 4A and 4 lesions were evaluated as BI-RADS 4B. Conclusion The ultrasonographic features of the traumatic neuroma after mastectomy in breast cancer patients are low echo lesions, which are located in the layer of the pectoralis major muscle, elipse, clear boundary, and parallel to the skin,which can be clearly displayed in connection with nerve fibers, and shows a hard mass in elastic imaging.

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吴海爽,周锋盛.乳腺癌切除术后创伤性神经瘤的超声表现[J].临床超声医学杂志,2019,21(7):

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  • 收稿日期:2018-07-12
  • 最后修改日期:2019-06-20
  • 录用日期:2018-09-30
  • 在线发布日期: 2019-07-23
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