乳腺肿块的超声造影特征与病理对照分析

发布时间：2018-03-13 19:10

本文选题：乳腺肿块　切入点：超声图像　出处：《中华肿瘤防治杂志》2016年10期 　论文类型：期刊论文

【摘要】：目的乳腺超声成像是乳腺疾病诊断不可或缺的主要技术,造影技术又克服了传统超声的局限性,极大提高了检测肿块低速血流的敏感性。本研究观察乳腺良恶性肿块的超声图像及超声造影表现,探讨其超声图像及超声造影的特征。方法对2013-01-01-2015-06-30在广西壮族自治区人民医院就诊及手术治疗的451例乳腺肿块患者的超声图像特征、血流情况进行观察及实时超声造影,选用SonoVue超声造影剂,对肿块的高频超声图像、造影增强形态、强度和造影时间-强度曲线特征进行观察,并与病理进行对照分析。结果经病理确诊451例乳腺肿块中,恶性肿块240例,良性肿块211例,超声造影有其特征性表现。(1)恶性肿块表现为进入丰富,分布尚均及不均。其造影强度分别为高增强188例(78.3%),中等增强43例(17.9%),极少至低增强9例(3.8%)。(2)进入肿块的增强范围常超过二维超声图像,周围可见多条粗大的血管进入肿块,恶性肿块范围增大、放射状增强、穿支血管均较良性明显增加,良性肿块可见环状增强,并为特征性改变,共59例(28.0%)。(3)本组恶性肿块超声造影敏感度92.45%,特异度95.91%,阳性预测值96.66%,阴性预测值90.82%。本组恶性肿块二维超声检查敏感度82.63%,特异度65.02%,阳性预测值60.40%,阴性预测值85.29%。结论通过系统地对乳腺恶性肿块超声图像及超声造影表现进行观察,进一步发现了不同乳腺肿块,尤其是恶性肿块的超声造影特征表现,认为超声造影可提高对乳腺肿块低速血流显示的敏感度,并有其特征性表现,有助于乳腺良恶性病变的鉴别诊断及提高诊断准确率。
[Abstract]:Objective mammography is an indispensable technique in the diagnosis of breast diseases, and the imaging technique overcomes the limitation of traditional ultrasound. The sensitivity of low velocity blood flow was greatly improved. In this study, ultrasound images and contrast-enhanced findings of benign and malignant breast masses were observed. Methods to investigate the features of ultrasound images and contrast-enhanced ultrasonography in 451 patients with breast masses who were treated and treated in Guangxi Zhuang Autonomous region people's Hospital from 2013-01-2015-06-30. The characteristics of ultrasound images, blood flow and real-time contrast-enhanced ultrasonography were observed. SonoVue contrast medium was used to observe the features of high frequency ultrasound image, enhanced morphology, intensity and time-intensity curve of mass, and to compare with pathology. Results the results showed that there were 451 cases of breast mass diagnosed by pathology. 240 cases of malignant mass, 211 cases of benign mass, contrast-enhanced ultrasonography has its characteristic features. The intensity of contrast enhancement was 78.3% in 188 cases with high enhancement, 17.9% in 43 cases with moderate enhancement, and 9 cases with little to low enhancement. The range of malignant masses was enlarged, radially enhanced, perforating vessels were significantly increased, and circular enhancement was observed in benign masses, which was characterized by characteristic changes. There were 59 cases of malignant masses with sensitivity 92.45, specificity 95.91, positive predictive value 96.66, negative predictive value 90.82.The sensitivity, specificity, positive predictive value and negative predictive value of this group of malignant masses were 82.63, 65.02, 60.40 and 85.29, respectively. The ultrasonographic and contrast-enhanced findings of malignant breast masses were observed systematically. We have further discovered the features of different breast masses, especially malignant masses, and considered that contrast-enhanced ultrasound can improve the sensitivity of low-velocity flow display of breast masses, and have its own characteristics. It is helpful to the differential diagnosis of benign and malignant breast lesions and to improve the diagnostic accuracy.
【作者单位】：广西壮族自治区人民医院超声科;广西壮族自治区人民医院病理科;
【基金】：广西科学研究与技术开发计划(桂科攻0592007-2c);广西科学研究与技术开发计划(桂科攻14124004-1-13) 广西医疗卫生重点科研课题(重200813)
【分类号】：R445.1;R737.9

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