超声造影在乳腺肿瘤中灌注模式的初步研究

Preliminary study of contrast ultrasonography on the perfusion pattern in breast tumor

目的:初步探讨超声造影在乳腺肿瘤中的灌注模式。方法:对常规超声发现的乳腺肿块25个(24例患者)术前进行了超声造影,观察肿块灰阶造影形态,绘制时间-强度曲线并进行分析,进一步经手术病理证实后,评价超声造影在乳腺肿瘤中的灌注模式。结果:25个乳腺肿块中,10个为良性,15个为恶性。超声造影对乳腺良、恶性肿瘤的灌注模式不同,恶性肿块造影剂出现早,到达峰值快,峰值强度大,消退快,消退模式有两种(快上单相慢下和快上多相慢下);良性肿块则出现晚,到达峰值慢,峰值强度小,消退慢,消退模式为一种(慢上慢下)。恶性组斜率和峰值到60s曲线下面积也较良性组大。结论:乳腺良恶性肿瘤的超声造影灌注模式不同,对于常规超声鉴别诊断乳腺肿瘤有困难者,超声造影有望成为首选的检查方法。

Objective： To study the perfusion pattern in breast tumor with contrast ultrasonography. Methods： 25 breast tumors （24 patients） found by routine ultrasound were performed with contrast ultrasonography, and then the gray-scale angiography morphology of tumor was observed, and the time-intensity curve was drawn and analyzed. The perfusion pattem in breast tumor was evaluated after the further confirmation by pathology. Results： Pathology confirmed that 10 tumors were benign lesions, 15 were carcinomas. The perfusion patterns of benign lesions and carcinomas were different. The contrast agent of carcinomas occurred early, reached its peak quickly, the intensity of peak value was big and cleared up quickly, and displayed two clear patterns （quick increase single-phase slow decrease and quick increase muhiphase slow decrease）; but the contrast agent of the benign lesions occurred late, reached its peak slowly, the intensity of peak value was small and cleared up slowly, and displayed only one clear pattern （slow increase slow decrease）. The slope rate and the area between peak value and the 60 s curve of carcinomas were larger than those of benign lesions. Conclusion： The perfusion patterns of the breast benign lesions and carcinomas are different. Contrast ultrasonography is a complementary test for patients difficult to diagnosed by routine ultrasound.