实时灰阶超声造影增强模式在乳腺良、恶性病灶诊断中的应用

Application of Real-time Gray-scale Contrast-enhanced Ultrasound in the Diagnosis of Benign and Malignant Breast Lesions

目的观察乳腺病灶实时灰阶超声造影增强模式,评价其诊断乳腺良、恶性病灶的临床价值。方法观察116个乳腺病灶(良性63个,恶性53个)的实时灰阶超声造影增强模式,并从以下几个方面进行评价:(1)增强程度;(2)增强方式;(3)是否完全增强;(4)是否均匀增强;(5)增强时病灶边界是否清晰;(6)病灶有无周边放射状增强。按照增强明显/不明显,向心/非向心、完全/不完全、均匀/不均匀,边界清晰/不清晰,周边出现/未出现放射状增强,对良、恶性病灶的增强模式进行研究。结果116个乳腺病灶中5个无增强,其余111个病灶有不同程度增强。良、恶性病灶增强模式,除是否明显增强一项特征外,差异均有显著性(P均<0.05)。恶性病灶多呈向心性、不均匀增强(83%、86.8%),增强时病灶边界不清(81.1%),出现不完全增强和病灶周边放射状增强两个征象的病灶中均以恶性占多数,分别为72.2%和96.8%。结论乳腺良、恶性病灶实时灰阶超声造影增强模式存在明显差异,具有一定的临床应用价值。

Objective To observe the patterns of benign and malignant breast lesions using real-time gray-scale contrast-enhanced ultrasound and assess value in the differential diagnosis of begign and malignant breast tumors. Methods Totally 116 breast lesions （ benignity n= 63 ; malignancy n = 53 ） underwent real- time gray-scale contrast-enhanced ultrasound. The patterns of their enhancement were assessed from 6 aspects ： degree of enhancement, process of enhancement, completeness of enhancement, homogeneity of enhancement, boundary of the enhanced lesions, and exhistance of radial enhancement around the lesions. The results were compared with the pathologic findings. Results Contrastenhanced sonographic patterns were significantly different between benign and malignant breast lesions. Most malignant lesions were non-centripetally, incompletely, and inhomogeneously enhanced. After having been injected with the microbubble contrast medium, the boundary of the lesions became unclear, and the radial enhancement around lesion were mainly seen in the malignant lesions. Conclusion The patterns of real-time gray-scale contrast-enhanced ultrasound are remarkably different between malignant and benign breast lesions, showing promising values for its clinical application.