乳腺良恶性病灶超声造影特征表现

Characterization of benign and malignant breast lesions in contrast enhanced ultrasound

目的 总结乳腺良恶性病灶超声造影的特征。方法 回顾性分析2013年4月至2013年11月在重庆医科大学附属第一医院就诊的92例乳腺肿块患者超声造影检查的结果,良恶性病灶的造影特征比较采用χ2检验,时间-强度曲线各定量参数比较采用t检验。结果 病理诊断93个病灶（1例患者有2个病灶）,其中恶性52个,良性41个。恶性病灶多表现为不均匀增强（90.39%,47/52）,以高增强为主（75.00%,39/52）,增强后边界均显示不清（100%,52/52）,部分见造影剂滞留（61.54%,32/52）和穿支血管显影（44.23%,23/52）。良性病灶表现为均匀增强（78.05%,32/41）,增强后边界多清晰（68.30%,28/41）,大部分无造影剂滞留（85.37%,35/41）及穿支血管显影（92.69%,38/41）。两组病灶的增强方式、增强后边界、造影剂滞留、穿支血管差异均具有统计学意义（χ2=44.814、50.810、20.871、15.509,P均〈0.001）,两组时间-强度曲线的开始增强时间、峰值强度比较差异具有统计学意义（t=2.027、-3.211,P=0.046、0.002）。结论 乳腺超声造影具有特征表现,结合时间-强度曲线分析可能是鉴别乳腺良恶性肿块的较好方法。

Objective To summarize the characteristics of benign and malignant breast lesions in contrast enhanced ultrasound （CEUS）. Methods Totally 92 patients treated in the First Affiliated Hospital of Chongqing Medical University from April 2013 to November 2013 underwent CEUS. The ultrasound characteristics of benign and malignant lesions were compared using Chi-square test and the quantitative parameters of time-intensity curve were compared using t test. Results There were 93 lesions （ only one patient had 2 lesions）, including 52 malignant lesions and 41 benign lesions confirmed by pathology. The malignant lesions were characterized by inhomogeneous enhancement （90. 39% ,47/52）, mainly highly-enhanced （75.00% ,39/52）, unclear border after enhancement （ 100% ,52/52） ,contrast agent retention （61.54% ,32/ 52） and visualization of penetrating vessels （44. 23%, 23/52）. The benign lesions were characterized by homogeneous enhancement （78.05% ,32/dl ） and clear border after enhancement （68.30% ,28/41 ）, with no contrast agent retention （ 85.37%, 35/41 ） and no visualization of penetrating vessels （ 92.68%, 38/41 ）. There were significant differences in enhancement homogeneity, margin, retention of contrast agent and penetrating vessel between benign and malignant lesions （X2 = 44. 814, 50. 810, 20. 871, 15. 509; all P〈 0. 001 ）. Wash-in-time and peak intensity in the time-intensity curve showed significant differences between benign and malignant lesions （ t = 2. 027, - 3.211 ; P = 0. 046, 0. 002 ）. Conclusion Contrast enhanced ultrasound, combined with the time-intensity curve may be a better method to improve the differential diagnosis of benian and malianant breast lesions.