探讨自动乳腺全容积成像冠状面"汇聚征"对乳腺病变的诊断价值。

选取2011年7月至2016年7月在杭州市第一人民医院就诊的经自动乳腺全容积成像（ABVS）扫查冠状面出现"汇聚征"的乳腺病灶共124个，分为肿块型与非肿块型2组，分别与病理结果相对照，得出冠状面"汇聚征"在肿块型组及非肿块型组的乳腺癌检出率，用χ²检验进行对比分析，评估冠状面"汇聚征"对乳腺病变的鉴别诊断价值。

124个乳腺病灶中89个为肿块型病变，35个为非肿块型病变。肿块型病变经病理证实为恶性71个，其中浸润性乳腺癌67个，非浸润性乳腺癌4个，良性病变18个（乳腺腺病11个，导管内乳头状瘤4个，不典型增生2个，放射状瘢痕1个），非肿块型病变经病理证实为恶性6个，其中，浸润性乳腺癌2个，非浸润性乳腺癌4个，良性病变29个（乳腺腺病25个，导管内乳头状瘤3个，纤维腺瘤1个）。冠状面"汇聚征"作为乳腺癌的一个诊断征象，在肿块型乳腺病变中的检出率为79.77%（71/89），高于非肿块型17.14%（6/35），差异有统计学意义（χ²=41.87，P<0.05）。本组共诊断77例乳腺癌，其中浸润性乳腺癌69例，非浸润性乳腺癌8例，冠状面"汇聚征"对浸润性乳腺癌的检出率为89.61%（69/77），显著高于非浸润性乳腺癌10.39%（8/77）。良性病变中，无论肿块型或非肿块型，乳腺腺病均是主要的病理类型，在肿块型中所占比例61.11%（11/18），非肿块型中86%（25/29）。

冠状面"汇聚征"是乳腺癌诊断的重要超声征象，尤其对于乳腺肿块型病变，且对浸润性乳腺癌更为敏感。而良性病变中间质增生、纤维化或胶原化是是造成假阳性的主要干扰因素，其中乳腺腺病是主要的病理类型。

To assess the value of the convergence sign on coronal plane images of automated breast volume scanning for the diagnosis of breast lesions.

One hundred and twenty-four pathologically proved breast lesions, including 89 mass cases and 35 non-mass cases, were retrospectively studied. The detection rates of breast cancer in the mass cases and non-mass cases were obtained by the convergence sign on coronal plane images of automated breast volume scanning and compared with those achieved by pathology, and the chi-square test was used to evaluate its value in the diagnosis of breast lesions.

In all, 89 mass cases and 35 non-mass-like cases were reviewed. In 89 mass lesions, 71 were malignant, including 67 invasive ductal carcinomas and 4 in situ ductal carcinomas, and 18 were benign, including 11 cases of adenopathy, 4 cases of intraductal papilloma, 2 cases of atypical hyperplasia, and 1 case of radial scar. In 35 non-mass cases, 6 were malignant, including 2 invasive ductal carcinomas and 4 in situ ductal carcinomas, and 29 were benign, including 25 cases of adenopathy, 3 cases of intraductal papilloma, and 1 case of adenofibroma. The convergence sign was more common in mass lesions, with a rate of 79.77% (71/89), compared with 17.14% in non-mass lesions (χ²=41.87, P<0.05). In all 77 malignant cases, the detection rate of the convergence sign in invasive cancer was 89.61% (69/77), significantly higher than that of in situ ductal carcinoma (10.39%, 8/77). In all benign cases, the main pathological type was adenopathy [61.11% (11/18) in mass lesions and 86% (25/29) in non-mass lesions].

The convergence sign on coronal plane images of automated breast volume scanning is an important feature for the diagnosis of breast cancer, especially for invasive ductal carcinoma, but benign lesions such as mesenchymal hyperplasia or fibrosis are the main cause of false-positives, in which adenopathy is the main pathological type.