乳腺肿瘤术后瘢痕超声光散射断层成像研究

Ultrasound-guided diffused optical tomography study of scar after breast tumor operation

目的 (1)观察乳腺良、恶性病变术后癜痕的超声定位光散射断层成像(DOT)特征,研究癜痕的总血红蛋白浓度随时间的变化规律。(2)观察乳腺良、恶性病变术后的声像图特征,研究癜痕大小、血流随时间的变化规律及其形态学特点。方法选择2016年11月～2018年2月,60个乳腺肿物切除术后的瘢痕进行研究,其中乳腺良性病变术后癜痕34个,乳腺癌术后瘢痕26个。进行常规超声检查,记录术后瘢痕各种超声征象。用超声定位光散射断层成像系统测量瘢痕内部总血红蛋白浓度(THC),并生成光吸收图。对瘢痕进行术后第3,6,12个月的定期随访。结果 (1)良、恶性病灶术后的瘢痕的THC与术后时间均呈幂函数关系;(2)术后瘢痕THC与术后时间呈线性负相关;(3)术后同一时间段内,乳腺良性病变术后瘢痕与恶性病变术后瘢痕的THC无明显差异;(4)彩色多普勒显示可探及丰富血流的瘢痕中多数为术后6个月内的瘢痕,而且瘢痕血流多数位于瘢痕周边。随着术后时间的延长,瘢痕血流数量逐渐减少。结论乳腺肿瘤局部切除术后瘢痕的THC变化具有一定规律性,有望在术后随访中为鉴别术后瘢痕与复发癌灶提供更多信息。

Objective(1)To study the relationship between the total hemoglobin concentration and postoperative time of the scar by using ultrasound-guided diffused optical tomography.(2)To observe the ultrasonographic characteristics of the scar of the benign and malignant lesion,to study the scar size,the blood flow variation with time and its morphological characteristics. Methods From November 2016 to February 2018,60 scars of excision of breast nodules were investigated which include 34 benign nodules scars nonmalignant breast nodules scars. Routine preoperative ultrasonography was carried out to record the various ultrasound signs. After the ultrasound showed a clear lesion,the ultrasound localization of light scattering tomography was utilized to measure the total hemoglobin concentration with in lesions( total heamoglobin concentration,THC),and generate the optical absorption map. They were selected for 3,6,12 months regufollow-up. Results(1)The THC in scar was correlated with the postoperative time as powerfunction;(2)The THC and the postoperative time are negative correlated;the THC and the postoperative time are negative correlated;(3)In the same period of time after operation,the scar formation of benign and malignant nodules performed no significant difference in THC;(4)The 86. 4%( 19/22) scar with rich blood flow detected by Color Doppler was the scar in 6 months postoperative,and the blood flow of scar was in the peripheral( 94. 7%). The blood flow of scar decreased with the postoperative time extension. The scar with rich blood flow detected by Color Doppler was the scar in 6 months postoperative,and the blood flow of scar was in the peripheral. The blood flow of scar decreased with the postoperative time extension. Conclusion Changes of the THC of incision area of breast lesions after local excision have regularity,which may provide useful information during follow-up for differential diagnosis between recurrent cancer and scar.