乳腺癌超声造影表现与病理组织分型及分级的关系

Correlation of Contrast-Enhanced Ultrasonography with Pathological Classification and Grading of Breast Cancer

目的探讨乳腺癌患者超声造影(contrast-enhanced ultrasonography,CEUS)的灌注模式与病理组织学分型及分级之间的关系。方法对132例乳腺癌患者进行术前CEUS检查,观察各个癌灶的灌注模式,并分析灌注模式与组织学分型及分级之间的关系。结果 132例乳腺癌CEUS表现以树枝状或环状不均匀高增强为主,占78.0%;灌注方式主要以快进慢退及快进延迟慢退为主,各占64.4%和32.6%。CEUS灌注模式与病理分型无明显关系(P>0.05)。不同组织学分级的患者在灌注期血管形态方面差异无统计学意义(P=0.097),但是在达峰期增强水平、达峰期增强形态及灌注方式方面差异有统计学意义(P=0.030、P=0.002,P<0.001)。结论乳腺癌患者CEUS灌注模式与病理组织学分级有一定的关系,癌灶的CEUS特点对组织学分级有提示作用。

Objective To investigate the correlation of perfusion pattern in contrast-enhanced ultrasonography（CEUS）with the pathological classification and grading of breast cancer.Methods Preoperative CEUS was performed to observe the perfusion pattern in 132 patients with breast cancer.The correlation of perfusion pattern with the pathological classification and grading of breast cancer was analyzed.Results Among the 132 patients,CEUS showed dendritic or cyclic uneven hyper-enhancement in 78.0%,and the perfusion pattern was fast wash-in and slow wash-out in 64.4% and fast wash-in and delayed slow wash-out in 32.6%.The pathological classifica-tion was not correlated with the perfusion pattern（P 〉0.05）.There were no obvious differences in vascular morphology among patients with different pathological grades during the perfusion pe-riod（P =0.097）.However,differences in the enhancement level and form during the peak period and the perfusion pattern were significant among patients with different pathological grades（P =0.030,P =0.002,P 〈0.001）.Conclusion There is a correlation between CEUS perfusion pattern and pathological grade and the CEUS characteristics may be a predictor of histological grade in patients with breast cancer.