超声造影在乳腺肿块良恶性鉴别诊断中的应用

Application of contrast-enhanced ultrasound in differential diagnosis of benign and malignant breast masses

目的观察乳腺肿块的超声造影增强模式特点,分析其时间-强度曲线,探讨超声造影在乳腺肿块良恶性鉴别诊断中的应用价值。方法对90例患者(共99个病灶)行超声造影检查,并与病理结果比较,分析其超声造影特点及时间-强度曲线。结果 73个恶性病灶的增强模式主要表现为持续性高增强,其中33个表现为快速均匀增强,40个表现为非均匀增强;26个良性病灶的增强模式主要为低增强,其中15个表现为均匀增强,2个表现为不均匀增强,9个表现为无增强,无周边放射状增强。恶性病灶造影后肿块增强范围大于常规超声显示范围,良性病灶造影后肿块增强范围与常规超声显示范围类似。良恶性病灶之间峰值强度比较差异有统计学意义(P﹤0.05),恶性病灶的时间-强度曲线与周围正常组织差异较大,而良性病灶的时间-强度曲线与周围正常组织相似。结论超声造影增强模式结合时间-强度曲线分析对乳腺肿块良恶性的鉴别诊断具有一定的价值。

Objective To explore the application value of contrast-enhanced ultrasound（CEUS）in differential diagnosis of benign and malignant breast masses by observing the enhancement pattern features and analyzing the time -intensity curves. Methods A total of 90 patients with 99 breast masses underwent CEUS,and correspondingly collected all histological results. The enhancement pattern features and time-intensity curves were analyzed. Results The enhancement pattern of 73 malignant lesions mainly showed the continued high-enhanced enhancement,including 33 quick homogeneous enhancement and 40 heterogeneous enhancement . The enhancement pattern of 26 benign lesions mainly showed the low - enhanced enhancement ,including 15 homogeneous enhancement,2 heterogeneous enhancement and 9 non-enhanced enhancement. The area after CEUS of malignant lesions was more than the area detected by conventional ultrasound. The area after CEUS of benign lesions was similar to the area detected by conventional ultrasound. There was significant difference in peak intensity between benign and malignant lesions（P﹤0.05）. The time-intensity curves of malignant lesions presented large difference with those of normal tissues around the lesions,however the time -intensity curves of benign lesions were similar to those of normal tissues around the lesions.Conclusion The CEUS enhancement pattern combined with the time-intensity curve has a certain value for differential diagnosis of benign and malignant breast masses.