实时灰阶超声造影评价乳腺导管内病变血流灌注特征的初步探讨

Assessment of perfusion characteristics of intraductal lesions of breast:preliminary result with real-time gray-scale contrast-enhanced ultrasound

目的分析乳腺导管内病变实时灰阶超声造影血流灌注特征,探讨良恶性病变增强的特点和差异。方法分析19例21个乳腺导管内病变的超声造影增强表现,比较研究良恶性病变血流灌注特征。结果虽然增强达峰值时恶性病变以整体增强为主(80%,4/5),良性病变以部分增强多见(68.7%,11/16),但两者间差异无统计学意义(p>0.05)。注射造影剂后62.5%的良性病变(10/16)呈点线状增强,80%的恶性病变(4/5)呈团块状增强,消退期全部良性病变均呈不均匀消退,40%的恶性病变(2/5)呈均匀消退。良恶性病变早期增强模式和消退方式间有明显差异(p<0.05)。结论实时灰阶超声造影可以动态观察乳腺导管内病变微血管血流灌注,研究良恶性病变灌注特征有助于提高此类疾病的诊断水平。

Obehectuve To investigate the perfusion characteristics of intraductal lesions of breast with real-time gray-scale contrast ultrasound and the diagnostic performance of perfusion imaging in intra-ductal lesions of breast. Methods 19 patients with 21 intraductal lesions of breast were included in this study. The perfusion characteristics were compared between the benign and malignant lesions. Results Although the gross enhancement type was mostly seen in malignant lesions（80%,4/5） and the partial enhancement was predominant in benign lesions（68.7%,1 1/16）, there was no significant difference between them（p〉0.05）. After injecton of SonoVue the spot/linear enhancement pattern was observed in 10 of 16 benign lesions （62.5%） and mass enhancement mostly in carcinomas（80%）（p〈0.05）.In the wash-out phase, all the benign lesions showed heterogeneous wash-out and homogeneous type was found in 2 of 5 carcinomas （19 〈0.05）. Conclusion The microvascular perfusion of intraductal lesions of breast can be clearly displayed by real time gray-scale contrast-enhanced ultrasound. The feasibility of differentiation between benign and malignant lesions according to their perfusion characteristics appears to be promising.