非哺乳期妇女乳腺炎性肿块的超声图像及造影特征探讨

Study on the characteristics of ultrasonography and contrast-enhanced ultrasonography in non-lactating women with mastitis masses

目的探讨非哺乳期妇女乳腺炎性肿块的超声图像及超声造影特征。方法收集该院2008-01~2016-1252例非哺乳期乳腺炎性肿块患者的影像学资料进行超声图像和超声造影特征分析。结果52例非哺乳期乳腺炎性肿块,其高频彩色超声图像表现为不规则实质低回声、混合型肿块、位置较表浅、与皮肤层分界不清、表面皮肤水肿增厚或层次模糊、肿块常有类似恶性肿瘤的表现。超声造影特征表现为非均质高增强强度,进入肿块的范围常较二维超声图像的范围明显增大,周围及内部有较粗大的条状血管增强;最具有特征性表现是丰富的造影剂进入后呈分隔状,内可见单个及多个无增强区,呈圆及椭圆状。彩色高频超声诊断符合率为57.69%(30/52),结合超声造影检查后诊断的符合率为82.69%(43/52),超声US-BI-RADS分级为Ⅲ~Ⅴ级。结论非哺乳期乳腺炎性肿块超声图像及超声造影可呈现一定的特征表现,两者结合检查有助于降低误诊及漏诊率,提高诊断符合率。

Objective To explore the characteristics of ultrasonography and contrast-enhanced ultrasonography(CEUS) in non-lactating women with mastitis masses.Methods The imaging data of 52 cases of mastitis masses of non-lactating patients receiving ultrasonography and CEUS for breast masses were collected in our hospital from January 2008 to December 2016. The charactristics of ultrasonography and CEUS were analyzed.Results In the 52 mastitis masses of the non-lactating women, their high frequency color ultrasound images showed irregular substantial low mixed echo located in a shallower position with unclear boundary of the skin, and the thickened surface skin edema or blurred layers. The masses of often have similar manifestations to malignant tumors. The characteristics of CEUS showed heterogeneous high enhancement, and the size of masses at CEUS examination appeared larger than that at conventional two-dimensional utrasonographic examination with enhancerment of larger striated vessels around and inside. The most characteristics of the CEUS showed a delimited state because of the entrance of high dose contrast agent with single and multiple round or oval areas without enhancement. The accuracy of high frequency color ultrasonography was 57.69%(30/52), and the accuracy of high frequency color ultrasonography combined with contrast-enhanced ultrasonography was 82.69%(43/52), US-BI-RADS was classified as Ⅲ~Ⅴ.Conclusion Ultrasonography and CEUS show some distinctive manifestations in mastitis masses and combination of the two examinations is helpful to reduce the rate of misdiagnosis and missed diagnosis, and increase the diagnostic coincidence rate.