乳腺导管内乳头状瘤的超声造影特征及定量参数分析

Analysis of contrast-enhanced ultrasound characteristics and quantitative parameters of breast intraductal papilloma

目的 通过对比乳腺导管内乳头状瘤与纤维腺瘤、浸润性导管癌超声造影的不同特征,探讨超声造影对乳腺导管内乳头状瘤的诊断价值。方法 选取自2020年1月至2021年11月新疆医科大学第一附属医院经病理证实为乳腺导管内乳头状瘤患者22例,及同期病理证实为纤维腺瘤患者32例、浸润性导管癌患者31例,回顾分析3组病例超声造影的定性及定量指标特征。结果 (1)超声造影定性分析结果:导管内乳头状瘤组超声造影后快速向心性高增强,增强后范围扩大比率高于纤维腺瘤组(P<0.05);导管内乳头状瘤组超声造影后内部充盈缺损,增强后范围扩大,周边汇聚征,向心性增强比率(9.1%、27.3%、4.5%、54.5%)均低于浸润性导管癌组(48.4%、90.3%、48.4%、87.1%),造影剂分布较浸润性导管癌组更均匀,差异具有统计学意义(P<0.05)。(2)超声造影定量参数分析结果:导管内乳头状瘤组的上升支斜率(K)及梯度(Grad)均小于浸润性导管癌组,峰值强度(A)高于纤维腺瘤组,差异具有统计学意义(P<0.05)。结论 乳腺导管内乳头状瘤具有较好的超声造影特征,超声造影对提高导管内乳头状瘤的诊断提供了更多有价值证据。

Objective To explore the diagnostic value of contrast-enhanced ultrasound(CEUS)for intraductal papilloma by comparing the different CEUS characteristics among breast intraductal papilloma(IDP),fibroadenomas(FAs)and infiltrating ductal carcinoma(IDC).Methods 22,32 and 31 patients with pathologically confirmed IDP,FAs and IDC of the breast from 1,2020 to 11,2021 were selected from hospitalfor retrospective analyzing the characteristics of the CEUS.Result(1)Qualitative analysis of CEUS:compared to FAs,the rate of rapid centripetal hyperenhancement and expanded range after CEUS were significantly higher in IDP group(P<0.05),compared to IDC,the rate of internal filling defect,expanded range after CEUS,peripheral convergence sign,centripetal hyperenhancement were significantly lower in IDP group(48.4%,90.3%,48.4%and 87.1%vs 9.1%,27.3%,4.5%and 54.5%),and the distribution of contrast agent was significantly uniform in IDP group(P<0.05).(2)Quantitative analysis of CEUS:compared to IDC,the slope and gradient of the ascending branch were significantly smaller in IDP(P<0.05),and the peak intensity was significantly higher in IDP group than FAs group(P<0.05).Conclusion CEUS characteristics of intraductal papilloma provided more valid and valuable evidence to improve the diagnosis of the lesions.