超声造影与二维超声在微波消融乳腺良性结节的应用比较

The application comparison of contrast-enhanced ultrasound and two-dimensional ultrasound for microwave ablation of breast benign nodules

目的比较超声造影(contrast-enhanced ultrasound,CEUS)和二维超声(two-dimensional ultrasound,2DUS)在引导微波消融(microwave ablation,MWA)治疗乳腺良性结节中的应用价值。方法回顾性分析我院2016年1月~2018年3月经MWA治疗乳腺结节的患者60例。根据引导方式分为超声造影组(CEUS组)30例和二维超声组(2DUS组)30例。评估两组患者术中及术后1、6、12个月的疗效。结果术中,CEUS组发现8个结节需补充治疗,2DUS组41个结节被彻底消融。术后1个月,MRI显示CEUS组43个结节完全凝固坏死,2DUS组检测到5个结节需补充治疗。术后1、6、12个月,CEUS组和2DUS组乳腺结节体积较治疗前均明显缩小(P<0.05),且术后12个月,CEUS组的结节体积又明显小于同时期的2DUS组;术后6、12个月CEUS组的临床有效率明显高于同时期的2DUS组(P<0.05)。结论CEUS在MWA治疗乳腺良性结节中能精准确定病灶位置、大小及血流分布,准确评价消融效果及时补充治疗,完全消融乳腺结节。

Objective To compare the application value of contrast-enhanced ultrasound(CEUS)and two-dimensional ultrasound(2DUS)in guiding microwave ablation(MWA)for breast benign nodules.Methods A retrospective study of 60 patients with benign breast nodules treated by MWA from 2016 to 2018 was conducted.According to the guidance mode,the patients were divided into CEUS group and 2DUS group.We evaluated the curative effect of two groups during operation and 1,6,12 months after operation.Results During operation,8 nodules in CEUS group were found to need additional therapy,41 nodules in 2DUS group were completely ablated.After 1 month of ablation,MRI showed that 43 nodules of CEUS group were complete coagulation and necrosis,five nodules were detected in the 2DUS group and needed additional treatment.After 1,6 and 12 months of operation,the volume of breast nodules of 2DUS group and CEUS group were significantly smaller than that before treatment(P<0.05),and the nodule volume of CEUS group was significantly smaller than that of 2DUS group after 12 months of operation.The clinical effective rate of CEUS group after 6 and 12 months of operation was significantly higher than that of 2DUS group of the same period(P<0.05).Conclusion CEUS can accurately determine the location,size and blood flow of lesion during treatment of breast benign nodules by MWA,accurately evaluate the ablation effect and timely provide supplementary treatment to achieve the complete ablation of breast nodules.