乳腺髓样癌的超声造影特征与病理对照

Characteristics of breast medullary carcinoma in contrast-enhanced ultrasound and comparison with pathology

目的分析乳腺髓样癌的超声造影特征,并与病理学对照。方法回顾性分析13例乳腺髓样癌患者的超声造影形态学特征,比较造影前后肿块横径、肿块与周围乳腺正常组织的时间-强度曲线定量参数,并进行统计学分析。将超声造影表现与病理表现相对照。结果乳腺髓样癌超声造影显示肿块形态不规则、边界清晰、内部均匀增强分别为10、11、11例,与病理形态学特征相符合。造影前后肿块横径差异无统计学意义(P=0.61),与病理学膨胀性生长方式相符合。与周围乳腺正常组织相比,髓样癌造影剂到达时间和达峰时间显著提前(P=0.034、0.021),峰值强度显著提高(P=0.005),与病理学上病灶内血管密度增高且分布均匀、病灶周边有较大管径血管的特征相符合。结论乳腺髓样癌特征性的超声造影表现有其病理学依据,可作为临床超声诊断和鉴别诊断的依据。

Objective To analyze the characteristics of breast medullary carcinoma in CEUS and to compare with pathologic features. Methods Morphologic characteristics of 13 breast medullary carcinomas in CEUS were analyzed. The diameter of mass before and after CEUS were compared. Parameters from time-intensity curves of masses were analyzed in contrast with peripheral breast parenchyma. All the results from CEUS analysis were compared with pathological manifestations. Results Breast medullary carcinoma was characterized as irregular shape （n=10）, clear margins （n=11） and uniform enhancement （n=11） in CEUS. These characteristics were in accordance with their morphologic characters in pathology. The diameter of mass before and after CEUS had no significant defference （P=0.61）, which was in accordance with expansive growth in pathology. In contrast with peripheral breast parenchyma, the arrival time and time to peak of breast medullary carcinoma were significantly shorter （P=0.034, 0.021）, and peak enhancement intensity was significantly stronger （P=0.005）, which were in accordance with the increased vascular density and their uniform distribution, big arteries at the margin of masses in pathology. Conclusion Breast medullary carcinoma has distinguished characteristics in CEUS, which are in accordance with characters in pathology, and can be used as the basis in clinical diagnosis and differential diagnosis of breast medullary carcinoma.