常规超声、弹性成像及超声造影对乳腺局灶性纤维化的诊断与鉴别诊断价值

Value of ultrasonography,elastosonography and contrast-enbanced ultrasound in diagnosis and differential diagnosis of focal fibrosis of the breast

目的探讨常规超声、弹性成像及超声造影对乳腺局灶性纤维化(FFB)的诊断与鉴别诊断价值。方法回顾性分析经病理证实的17例FFB、49例乳腺浸润性导管癌(IDC)及34例乳腺纤维腺瘤(FA)患者的常规超声、弹性成像及超声造影图像特征,结果进行对比分析。结果 FFB声像图表现为边界不清、高回声晕,后方回声衰减及内部回声不均匀的检出率与IDC相近,但高于FA(P<0.05);FFB病灶内部钙化灶及血流信号的检出率低于IDC(P<0.05);FFB的弹性成像评分与IDC相近,但高于FA(P=0.000)。FFB超声造影表现为病灶低增强,呈"晚进晚退"的征象均高于IDC和FA(均P<0.05);见扭曲大血管的征象均低于IDC和FA(P=0.000、0.042)。结论常规超声及弹性成像对FFB与乳腺IDC的鉴别诊断有限,超声造影对FFB鉴别诊断具有价值,应作为首选检查方法。

Objective To explore the value of ultrasonography,elastosonography and contrast-enhanced ultrasound（CEUS） in the diagnosis and differential diagnosis of focal fibrosis of the breast（FFB）.Methods The preoperative ultrasonographic characteristics results among 17 cases of FFB,49 cases of breast invasive ductal carcinoma（IDC）and 34 cases of fibroadenoma（FA）which all confirmed by were retrospectively comparative analyzed.Results The detection rate of the image performances of FFB which performed as obscure boundary,high echo halo,rear echo attenuation and inhomogeneous internal echo was similar to IDC group,while higher than the group of FA（P0.05）.The detection rate of internal calcification and blood flow signal of FFB was lower than IDC group（P0.05）.The average elasticity score of FFB was similar to IDC group,while higher than FA group（P=0.000）.The image features of CEUS in FFB which performed as lesion with low enhancement,＂into in late,fade late＂were more common than that in IDC group and FA group（all P0.05）,the sign of twisted large blood vessel in FFB was less common than that in IDC group and FA group（P=0.000,0.042）.Conclusion The value of ultrasonography and elastosonography in differential diagnosis of FFB and IDC in pre-operation is limited.CEUS has a certain value in differential diagnosis of FFB,it should be checked as the preferred method.