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本文报告经手术及病理证实直径≤２．０ｃｍ的乳腺肿物６１例，计７３个病灶的彩色多普勒（ＣＤＩ）超声检查结果。其中，恶性病变３９例，计４３个病灶；良性病变２２例，计３０个病灶。提出了我们的ＣＤＩ半定量分型标准（ＣＤＩ－ＨＱＡ）：Ⅰ型：病变区０～１处探及浅淡小点状血流信号，多单色、无彩色混叠现象，且血流信号主要出现于病灶周边部。Ⅱ型：病变区１～２处探及较亮点状，细条状血流信号，可有彩色混叠现象。血流信号以周边为主，偶见伸入病灶实质内。Ⅲ型：病变区３处以上探及明亮粗大点状和／或条状、树枝状血流信号，且病灶周边和实质内均易探及，并常有彩色混叠现象。我们将病灶血供属Ⅱ～Ⅲ型者，Ｖｍａｘ≥０．２０ｍ／ｓ和ＲＩ≥０．７０作为恶性肿瘤的阳性诊断指标；提出将其中二项以上指标呈阳性表现者作为小乳腺癌的诊断标准。结果本组诊断敏感性达９０．７％（３９／４３），特异性达９０％（２７／３０），准确性达９０．４％（６６／７３），优于彩色多普勒半定量、阻力指数或最高流速的单一指标分析法（Ｐ值＜０．０１），提高了彩超对≤２．０ｃｍ乳腺癌的诊断能力。初步结果表明，这种小乳腺癌彩超检查综合分析法，在临床应用中具有更客观准确、简便实用的优点。
This article reports 61 cases of breast masses with a diameter of ≤ 2.0 cm and a color Doppler (CDI) ultrasound result of 73 lesions that have been surgically and pathologically confirmed. Among them, 39 cases of malignant lesions included 43 lesions; 22 cases of benign lesions included 30 lesions. We proposed our CDI semi-quantitative typing standard (CDI-HQA): Type I: exploration of paleo-spotted blood flow signals from 0 to 1 lesion area, multiple monochromatic, achromatic, and blood flow signals. Mainly in the periphery of the lesion. Type II: The lesion area 1 to 2 probes brighter spots, thin strips of blood flow signals, there may be color aliasing phenomenon. The blood flow signal is mainly peripheral, with occasional extension into the essence of the lesion. Type III: exploration of bright and large spots and/or strips and dendritic blood flow signals at 3 or more sites in the affected area, and the surrounding and parenchyma of the lesions are easily probed, and there are often color aliasing phenomena. We diagnosed patients with type II to type III lesions with Vmax ≥ 0.20 m/s and RI ≥ 0.70 as positive diagnostic indicators for malignant tumors; we proposed the diagnosis of small breast cancer with positive performance of more than two indicators. standard. Results The sensitivity of this group was 90.7% (39/43), specificity was 90% (27/30), and the accuracy was 90.4% (66/73). It was superior to color Doppler semi-quantitative, The single index analysis method of the resistance index or the maximum flow rate (P value < 0.01) improved the color Doppler ultrasound diagnosis of breast cancer less than or equal to 2.0 cm. The preliminary results indicate that this comprehensive analysis method for color ultrasonography of small breast cancer has more objective, accurate, simple and practical advantages in clinical application.