Abstract: Objective　To analyze the differences of clinical symptoms and ultrasonic image features between benign and malignant non-mass-like breast lesions and to investigate their diagnostic values. Methods　A total of 229 non-mass-like breast lesions detected by ultrasound in 210 female patients aged (44.3±11.1) years were retrospectively analyzed in The Second Affiliated Hospital, Guangzhou University of Chinese Medicine from June 2017 to July 2019. The differences of clinical symptoms and ultrasonic image features were compared between the benign and malignant groups. The ultrasonic image features included size, orientation, cord-shaped hypoecho in the lesion, echo pattern, posterior features, calcification, associated features, and blood flow signal. Independent sample t test was used to compare the measurement data, and χ² test or Fisher's exact probability method was used to compare the count data. Results　A total of 71 malignant lesions and 158 benign lesions were confirmed by surgery or biopsy. There were statistically significant differences in clinical symptoms, cord-shaped hypoecho in the lesion, echo pattern of lesions, calcification, associated features, and blood flow between the benign group and the malignant group (all P<0.05); in the benign group, the echo pattern of lesions was mainly type Ⅱa and Ⅴ, while in the malignant group, it was mainly type Ⅰb and Ⅱb; there were no statistically significant differences in the size, orientation, and posterior features (all P>0.05). Conclusion　There are some differences in the clinical symptoms and ultrasonic image features between benign and malignant non-mass-like breast lesions, which may be helpful to the differential diagnosis for non-mass-like breast lesions.

Key words: Breast, Non-mass-like lesions, Ultrasonic image features, Clinical symptoms

摘要： 目的　探讨良恶性非肿块型乳腺病变的临床症状和超声图像特征的对比差异及其诊断价值。方法　回顾性分析广州中医药大学第二附属医院2017年6月至2019年7月经超声检出的210例女性患者［年龄（44.3±11.1）岁］共229个非肿块型乳腺病灶。比较良性组与恶性组的临床症状及超声图像特征差异，超声图像特征包括大小、生长方位、病灶内是否存在条索状低回声、回声模式、后方特征、钙化、伴随特征及血流信号。计量资料的比较采用独立样本t检验，计数资料的比较采用χ²检验或Fisher确切概率法。结果　经手术或穿刺活检病理证实71个病灶为恶性，158个病灶为良性。非肿块型乳腺病变良性组与恶性组在临床症状、病灶内条索状低回声、病灶回声模式、钙化、伴随特征、血流情况方面差异均有统计学意义（均P<0.05），良性组病灶回声模式以Ⅱa、Ⅴ类为主，恶性组更多地表现为Ⅰb、Ⅱb类，而在大小、生长方向、后方特征上差异均无统计学意义（均P>0.05）。结论　良恶性非肿块型乳腺病变临床表现及超声声像图具有一定差异，有助于非肿块型乳腺病变的良恶性鉴别。

关键词: 乳腺, 非肿块型病变, 超声图像特征, 临床表现