超声造影在乳腺囊实性复合肿块良恶性鉴别诊断及指导活检决策中的价值

Value of contrast-enhanced ultrasound in the differential diagnosis of benign and malignant complex cystic and solid breast masses and guided the biopsy decision

目的探讨超声造影在乳腺囊实性复合肿块良恶性鉴别诊断及指导活检决策中的价值。方法选取乳腺囊实性复合肿块患者74例,其中经病理证实60例(良性45例,恶性15例),比较良恶性乳腺囊实性复合肿块的超声造影特征。分析超声造影指导乳腺囊实性复合肿块活检决策的情况。结果超声造影显示良恶性乳腺囊实性复合肿块实性部分有无增强、增强范围有无增大及实性部分有无突破基底部比较差异均有统计学意义(均P<0.05)。74例患者中,19例常规超声检查示肿块内见实性成分,但超声造影检查示肿块内部无增强,囊壁增强厚度无增厚,建议随访观察,其中14例随访1年乳腺肿块无变化,余5例患者要求手术,病理结果均为良性。超声造影指导乳腺囊实性复合肿块活检决策改变25.7%(19/74)。结论超声造影在乳腺囊实性复合肿块良恶性鉴别诊断及指导活检决策中具有重要价值。

Objective To explore the value of contrast-enhanced ultrasound(CEUS)in the differential diagnosis of benign and malignant complex cystic and solid breast masses and guided the biopsy decision.Methods A total of 74 patients with complex cystic and solid breast masses were selected,among them there were 60 cases confirmed by pathology(45 cases were benign,15 cases were malignant),the CEUS characteristics of benign and malignant complex cystic and solid breast masses were compared.The condition of CEUS guided the biopsy decision was analyzed.Results CEUS showed that there were significant differences in whether solid composite enhanced,enhancement area enlarged,and enhancement range breakout basilar part between benign and malignant complex cystic and solid breast masses(all P<0.05).In 74 patients,conventional ultrasound showed that solid composite in masses in 19 cases,while CEUS showed no enhancement in masses,and no enhancement of capsule wall thickness,so that follow up observation was recommended.14 of them were followed up for 1 year without any change in breast masses,the rest 5 patients were benign confirmed by surgery.The decision had been changed in25.7%(19/74)breast masses for CEUS guided biopsy.Conclusion CEUS plays an important role in the differential diagnosis of benign and malignant complex cystic and solid breast masses and guided the biopsy decision.