乳腺肿块血管结构的超声三维灰阶容积、彩色多普勒能量图及灰阶血流成像表现

Three-dimensional gray-scale volume ultrasound,CDE and B-Flow imaging manifestations of vascular structure of breast masses

目的探讨乳腺肿块血管结构的三维超声成像表现及特征。方法用超声三维灰阶容积成像、彩色多普勒血流显像(CDFI)或彩色多普勒能量图(CDE)及灰阶血流(B-Flow)成像检查50例乳腺病变,动态观察病灶形态、血管结构及分布。结果容积成像中,"汇聚征"为恶性肿瘤主要特征,其中典型"汇聚征"占75.00%(15/20),不典型占15.00%(3/20);CDE及B-Flow示血管结构以病灶为中心,主干有分支,血管分支局部增多;血管明显增生25.00%,中等增生40.00%,少量增生35.00%。良性肿瘤、炎症病变亦可出现"汇聚征"(2/30,6.67%)。良性肿瘤血管进入肿块内分支细密,动静脉伴行,血流丰富;明显增生26.32%,中度和少许增生各36.84%。乳腺其他病变血管增粗,血管显著增生达80.00%。结论乳腺良恶性肿瘤、炎性病变超声三维成像表现为"汇聚征",血管结构不同程度增生;B-Flow血管纹理清楚、真实、自然,对乳腺疾病诊断有一定价值。

Objective To observe the manifests and characteristics of vascular structure of breast masses in three-dimensional ultrasound.Methods In 50 patients,gray-scale volume,color Doppler flow imaging（CDFI）,color Doppler energy（CDE）and B-Flow were used to observe the shape of lesions,vascular structure and distribution dynamically.Results Convergence sign was the main characteristic of breast cancers,which was typical in 75.00%（15/20）and atypical in 15.00%（3/20）lesions.In CDE and B-Flow,holding lesions as a center,the branches of vascular increased locally,obvious hyperplasia was found in 25.00%,while moderate and light hyperplasia was detected in 40.00% and 35.00% lesions,respectively.Convergence sign was also observed in few benign tumors and inflammatory lesions（2/30,6.67%）.In benign tumors,vessels,including arteries and companion veins were dense,blood was rich,obvious hyperplasia was found in 26.32%,while moderate and light hyperplasia was both found in 36.84%.In other breast diseases,vascular wall thickened,and obvious hyperplasia was found in 80.00%.Conclusion In three-dimensional ultrasound imaging,convergence sign and vascular hyperplasia present in breast cancers,benign tumors and inflammatory lesions.Vascular structure of breast masses can be depicted clearly in B-Flow,which has some value in diagnosis of breast diseases.