能量多普勒及超声造影微血管成像对乳腺癌及癌前病变微血管生长变化的评价

Evaluation on angiogenesis of breast carcinoma and precancerous lesion with power Doppler imaging and contrast enhanced microvascular imaging

目的探讨正常乳腺、单纯增生、非典型增生、导管内原位癌、浸润性导管癌的微血管生长变化特征。方法应用能量多普勒（PDI）、实时超声造影微血管成像（MVI）技术检测20例正常乳腺、20例单纯增生、20例非典型增生（AH）、20例导管内原位癌、30例浸润性导管癌微血管数目、形态及分布特征，免疫组化技术检测微血管密度（MVD）。结果随病程演进，MVD增加，PDI血流分级增高，MVI显示血管数目增多，由病灶周边进展为病灶内扩张、扭曲的血管出现，紊乱的血管网形成，但在病程初期改变不明显，显著变化始于AH阶段。结论PDI、超声造影MVI能够一定程度上反映乳腺癌及癌前病变组织微血管生长变化规律，是用于高危人群监测随访无创而实用的手段。

Objective To investigate the angiogenesis characteristics of normal breast, simple hyperplasia, atypical hyperplasia, intraduetal carcinoma in situ and invasive duetal carcinoma. Methods Twenty eases in normal controls,20 eases with simple hyperplasla,20 eases with atypical hyperplasia,20 cases with intraductal carcinoma in situ and 30 cases with invasive ductal carcinoma were inspected with power Doppler imaging （PDI） and contrast enhanced microvascular imaging （MVI） on the quantity, configuration and distribution of angiogenesis. The microvessel density （MVD） were detected by immunohistochemical technique. Results With the progression of breast cancer, MVD and grades of PDI kept increasing. Meanwhile, the blood vessels became twisted and increased in quantity with expansion into the lesion, the configuration of blood vessels became disordered. However, the changes mentioned above were not obvious in the very early stages, they became significant from the atypical hyperplasia（AH） stage. Conclusions Contrast MVI and PDI may be useful to screen high risk population with high risk of breast cancer due to their detection of changes in angiogenesis of breast carcinoma and precancerous lesions.