超声造影联合弹性成像对乳腺髓样癌的诊断价值

Value of ultrasonic elastography combined with contrast-enhanced ultrasound to the diagnosis of medullary cancer of breast

目的探讨超声造影及弹性成像联合应用对乳腺髓样癌的诊断价值。方法回顾性分析41例经手术组织病理检查证实的乳腺髓样癌超声造影及弹性成像表现特征,比较常规超声,弹性成像、超声造影、弹性成像联合超声造影应用对乳腺髓样癌的诊断符合率。结果乳腺髓样癌超声造影低增强、等增强、高增强的发生率(19.5%、36.6%、43.9%)比较差异均无统计学意义(P>0.05),病灶内部以均匀性增强为主,病灶边缘多无放射状增强,造影后病灶的径线无扩大;弹性成像评分≤3分19例(46.3%),评分≥4分22例(53.7%);常规超声、超声造影、弹性成像以及弹性成像联合超声造影对乳腺髓样癌的诊断符合率分别为65.8%、68.3%、53.7%和73.2%,诊断符合率比较差异均无统计学意义(P>0.05)。结论超声造影和弹性成像单独应用及联合应用对乳腺髓样癌的诊断价值均较低;了解乳腺髓样癌超声造影及弹性成像特征可减少误诊,必要时可行超声引导下组织穿刺活检以明确诊断。

Objective To explore the value of ultrasonic elastography（UE）combined with contrast-enhanced ultrasound（CEUS）to diagnosing medullary cancer of breast. Methods The UE and CEUS features of 41 patients with histopathologically confirmed medullary cancer of breast were retrospectively analyzed to compare the diagnosis accordance rates of UE,CEUS and joint detection of them two for medullary cancer of breast.Results There were no significant differences in the incidence of hypoecho-enhancement,isoechoic-enhancement and hyperecho-enhancement on CEUS（19.5%,36.6%,43.9%）（P〉0.05）.And inside the cancer,the image mainly showed homogeneous enhancement,no radial enhancement around the tumor and no enlarged diameter of the tumor.UE image score was ≤3 in 19 patients（46.3%）and≥4 in 22 patients（53.7%）.The diagnosis accordance rates of routine ultrasound,CEUS,UE and the joint detection of CEUS and UE were 65.8%,68.3%,53.7% and 73.2%,respectively,showing no significant differences（P〉0.05）.Conclusion CEUS,UE and joint detection of them have low values to the diagnosis of medullary cancer of breast.To understand the CEUS and UE image features contributes to reducing the misdiagnosis of medullary cancer of breast.Ultrasound guided biopsy is necessary for a definitive diagnosis.