乳腺良恶性肿块超声造影特征的研究

发布时间：2018-05-17 04:10

本文选题：超声造影 + 乳腺肿块　；参考：《青海大学》2014年硕士论文

【摘要】：目的：探讨乳腺良恶性肿块的超声造影(CEUS)增强模式及其时间-强度曲线（TIC）参数特征，为乳腺肿块的早期鉴别诊断提供影像学依据。方法：研究对象选自2012年12月至2013年12月青海大学附属医院拟诊为乳腺肿瘤的患者46人，肿块50个。首先利用常规二维及彩色多普勒超声(US)检查患者并获得最佳肿块切面图像，记录肿块的数目、位置、大小、内部回声，纵横比及内部血流情况；然后切换到造影模式，通过肘正中静脉快速注射微气泡超声造影剂SonoVue5ml，然后推注10ml生理盐水，观察造影动态过程6min,图像及造影过程存盘并待脱机分析。感兴趣区选定为病灶内造影剂灌注分布最强区域,通过软件自动绘制时间-强度曲线（TIC）获取造影峰值时间(TTP),始增时间(AT)、曲线下面积(AUC)及峰值强度(PI)等参数。及时对患者进行随访，并将报告结果与术后病理结果相比较。并对所得数据进行统计学分析处理。结果：1、46名受检者的50个乳腺肿块中良性肿块25例，超声造影特征性表现主要以无增强和均匀增强为主，增强后肿块边界多清晰光整，时间-强度曲线主要以快出型多见。2、46名受检者的50个乳腺肿块中恶性肿块25例，造影特征性表现主要以不均匀增强及周边增强为主,增强后肿块多边界不清晰，周边有穿支血管，，内部可见血流灌注缺损,且造影增强范围比常规超声测值增大，时间-强度曲线主要以快进慢型多见。3、良恶性乳腺肿块造影参数中始增时间(AT)差异不存在统计学意义(P〉0.05),而良恶性肿块间造影的峰值强度(PI)、达峰时间(TTP)、曲线下面积(AUC)等参数差异均有统计学意义(P〈0.05)。结论：乳腺良恶性肿块的超声造影增强模式及其时间-强度曲线参数特征差异具有统计学意义，超声造影有望根据其进行较为准确的鉴别诊断，成为一种乳腺肿瘤的术前无创、快捷的影像学方法。
[Abstract]:Objective: to investigate the enhanced mode of contrast-enhanced ultrasound (CEUs) and its time-intensity curve (TIC) parameters in benign and malignant breast masses, and to provide imaging evidence for the early differential diagnosis of breast masses. Methods: from December 2012 to December 2013, 46 patients with breast tumors were selected from affiliated Hospital of Qinghai University. First, the patients were examined with conventional two-dimensional and color Doppler ultrasound (USS) and the optimal mass section images were obtained. The number, location, size, internal echo, aspect ratio and internal blood flow of the masses were recorded, and then switched to the contrast mode. The microbubble ultrasound contrast agent SonoVue 5ml was injected quickly through the median elbow vein and then injected with 10ml saline. The dynamic process of the imaging was observed for 6 minutes and the images and the imaging process were saved and analyzed offline. The region of interest was selected as the strongest area of the distribution of contrast media perfusion in the lesion. The parameters such as the peak time and the peak time of TTP, the area under the curve, and the peak intensity were obtained by the software automatic drawing of time-intensity curve (TICs). Patients were followed up in time, and the reported results were compared with postoperative pathological results. The data were analyzed and processed statistically. Results among the 50 breast masses, 25 cases were benign masses. The main features of contrast-enhanced ultrasonography were non-enhancement and homogeneous enhancement, and the margin of the mass was clear and smooth after enhancement. Among 50 breast masses, 25 cases were malignant masses in which the time-intensity curve was mainly fast out of 46 patients. The characteristic features of the enhancement were mainly non-uniform enhancement and peripheral enhancement, and the multi-boundary of the masses was not clear after enhancement. There were perforating vessels around, blood perfusion defects could be seen inside, and the range of contrast enhancement was larger than that measured by conventional ultrasound. The time-intensity curve was mainly fast-forward and slow-type. 3. There was no significant difference of ATT in the parameters of benign and malignant breast masses (P > 0.05), but the peak intensity of contrast imaging between benign and malignant masses was PII, the peak time was TTPT, and under the curve, there was no significant difference between benign and malignant breast masses (P > 0.05). There were significant differences in AUC and other parameters (P < 0.05). Conclusion: contrast-enhanced mode and time-intensity curve parameters of benign and malignant breast masses have statistical significance. Contrast-enhanced ultrasonography is expected to be a noninvasive preoperative diagnosis of breast tumors. Quick imaging methods.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R737.9

【参考文献】