彩色多普勒超声对乳腺主要供血动脉与乳腺肿物的相关性研究

Study on the correlation between breast main feeding arteries and breast tumors by color Doppler ultrasonography

目的应用彩色多普勒超声(CDFI)对乳腺主要供血动脉与乳腺肿物大小、部位、性质相关性的初步研究。方法对各种的乳腺肿物患者行CDFI检查,扫查双侧乳腺胸外侧动脉(LTA)、胸廓内动脉穿支(IMAPS),测量并记录乳腺肿物大小、部位、数目及乳腺主要供血动脉的血流动力学参数[峰值流速(PS)、阻力指数(RI)、内径],并选取经病理证实168例良、恶性乳腺肿物患者进行分组,分析乳腺肿物大小、部位、性质与供血动脉的相关性。结果乳腺外象限的肿物主要由LTA供血,乳腺内象限的肿物主要由IMAPS供血,个别位置靠近6点、12点方位的肿物可由LTA或IMAPS交叉供血,6点、12点方位肿物可由LTA、IMAPS单独或共同供血;恶性肿物组肿物供血动脉PS增高、RI减低,内径增宽,与健侧对比差异有统计学意义(P<0.05),良性肿物组患侧与健侧对比差异无统计学意义(P>0.05);良性肿物组中肿物直径>2 cm、直径≤2 cm及肿物单发、多发,其供血动脉血流动力学参数与健侧对比差异无统计学意义(P>0.05)。相反,恶性肿物组中不同直径与数目的肿物其供血动脉血流动力学参数与健侧对比差异有统计学意义(P<0.05)。结论乳腺肿瘤供血动脉的来源与肿物位置有一定的相关性;供血动脉血流动力学参数与肿物的良恶性存在相关性,与肿瘤大小、数目无明显相关性;应用CDFI测定肿物主要供血动脉的内径、PS、RI,可作为乳腺癌有价值的诊断指标之一。

Objective To conduct a preliminary study on the correlation between breast main feeding arteries and size, location, and character of breast tumors by using color Doppler flow imaging （CDFI）. Methods CDFI examination was performed among the patients with various breast tumors, bilateral breast lateral thoracic artery （LTA） and internal thoracic artery perforator （IMAPS） were scanned, the size, location, number of breast tumors, and hemodynamic parameters [ peak systolic velocity （PS）, resistance index （RI）, internal diameter）] of breast main feeding arteries were measured and recorded. A total of 168 patients with benign and malignant breast tumors were selected and confirmed by pathological examination, the correlations between size, location, character of breast tumors and breast main feeding arteries were analyzed. Results Breast tumors in outer quadrant were mainly fed by LTA, breast tumors in internal quadrant were mainly fed by IMAPS. Breast tumors near the position of 6 o＇clock and 12 o＇clock points were mainly fed by LTA or IMPAS alone in the same side. Breast tumors in the position of 6 o＇clock and 12 o＇clock points were mainly fed by LTA alone, IMPAS alone or LTA and IMPAS together. In malignant tumor group, PS of breast tumors main feeding arteries increased, RI decreased, internal diameter increased, compared with contralateral healthy breast feeding arteries, there were statistically significant differences （ P〈0. 05 ） ; while in benign tumor group, there was no statistically signifi- cant difference （P〉0. 05）. There was no statistically significant difference in hemodynamic parameters between breast tumors main feeding arteries and contralateral healthy breast feeding arteries among benign breast tumors patients with tumor diameter〉2 cm, tumor diameter≤2 cm, single tumor, muhiple tumors （P〉0. 05）. There were statistically significant differences in hemodynamic parameters between breast tumors main feeding arteries and contralateral healthy breast feeding arteries among malignant tumors patients with different tumor diameters and tumor numbers （P〈0. 05）. Conclusion There is a certain correlation between the source of breast tumors feeding arteries and tumor location ; hemodynamic parameters of feeding arteries are correlated with tumor character, which are not correlated with tumor size and number; detecting internal diameter, PS, and RI of breast tumors feeding arteries by CDFI has value in diagnosis of breast cancer.