分析妊娠哺乳期乳腺疾病超声诊断质量和误诊原因，探讨提高超声诊断准确性的措施。

收集2016年1月至2019年12月北京协和医院手术病理诊断的妊娠哺乳期乳腺疾病患者44例，年龄（33.41±5.11）岁。分析术前超声描述、诊断符合率、检查医师等资料。采用χ²检验比较不同年资检查医师（初中级职称医师14人和高级职称30人）和不同专业组超声医师（乳腺专业组27人与非乳腺专业组17人）的超声诊断符合率有无差异。

44例超声报告均描述完整。37例（84.1%）与病理结果符合，7例（15.9%）与病理结果不符合，其中2例浸润性导管癌、1例导管内癌及1例浸润性微乳头状癌超声误诊为良性，2例腺病和1例导管内乳头状瘤超声误诊为恶性。初中级与高级职称医师超声诊断符合率分别为78.6%和86.7%，2组诊断符合率比较，差异无统计学意义（χ²=0.468，P=0.662）；乳腺专业与非乳腺专业组医师的诊断符合率分别为92.6%和70.6%，2组诊断符合率比较，差异无统计学意义（χ²=0.089，P=0.089）。

妊娠哺乳期乳腺疾病超声诊断有一定难度，超声医师应熟悉声像图特征，细致全面检查，紧密结合临床。

To analyze the quality of ultrasound diagnosis and the causes of misdiagnosis of breast disease during pregnancy and lactation, and to explore the measures to improve the accuracy of ultrasound diagnosis.

From January 2016 to December 2019, 44 patients with gestational and lactational breast disease diagnosed by surgical pathology at Peking Union Medical College Hospital were analyzed, with an average age of (33.41±5.11) years. Ultrasound description, diagnostic accuracy, and examiner seniority were analyzed. Chi-square test was used to compare the ultrasound diagnosis between different seniority groups (ultrasound examiners included 14 residents/attending sonographists and 30 professors; there were 27 breast sonographists and 17 non-breast sonographist).

All 44 cases were described completely. The ultrasound diagnoses of 37 cases (84.1%) were consistent with the pathological results, and inconsistent diagnoses occurred in 7 cases (15.9%). Among the 7 misdiagnosed cases, 2 cases of invasive ductal carcinoma, 1 case of intraductal carcinoma, and 1 case of invasive micropapillary carcinoma were misdiagnosed as benign, and 2 cases of adenosis and 1 case of intraductal papilloma were misdiagnosed as malignant. The diagnostic accuracy by residents/attending sonographists and professors was 78.6% and 86.7%, respectively, and there was no significant difference between the two groups (χ²=0.468, P=0.662). The diagnostic accuracy by breast specialists and non-breast specialists was 92.6% and 70.6%, respectively, and there was also no significant difference between them (χ²=3.776, P=0.089).

Ultrasound diagnosis of breast disease during pregnancy and lactation is difficult. Sonographists should be familiar with the sonographic features, examine the lesions carefully and comprehensively, and make a diagnosis on the basis of clinical manifestations.