超声造影在乳腺囊肿治疗中的临床应用价值

Clinical value of contrast-enhanced ultrasonography in the treatment of breast cysts

目的:通过超声造影对乳腺囊肿进行分型为乳腺囊肿的治疗提供科学依据。方法:对45例常规超声检查诊断为乳腺囊肿的患者行外周静脉注射超声造影剂,其中对诊断为分隔型囊肿行囊内注射超声造影剂观察囊肿造影剂的灌注情况,对诊断为单纯性囊肿及单纯分隔型囊肿行囊肿硬化治疗,对诊断为厚壁型囊肿行手术切除治疗,对诊断为导管扩张症行随诊观察。结果:45例患者中,20例为单纯性囊肿,25例为复杂囊肿,复杂囊肿中19例为分隔型囊肿并对其行囊内超声造影检查(其中3例导管扩张症、16例单纯分隔型囊肿),6例为厚壁型囊肿(其中4例为导管内乳头状瘤、1例为导管内乳头状癌、1例为乳腺浸润性导管癌)。36例囊肿行硬化治疗,6例行手术切除治疗,3例导管扩张症行随诊观察。结论:超声造影能够较准确的评判乳腺囊肿的分型,对指导乳腺囊肿治疗方式的选择有重要的临床应用价值。

Objective:To classify breast cysts through contrast-enhanced ultrasound and provide scientific basis for the treatment of breast cysts.Methods:Forty-five patients diagnosed with breast cysts by routine ultrasound were treated with peripheral intravenous injection of ultrasound contrast agent.Among them,intracapsular injection of ultrasound contrast agent was performed to observe the perfusion of contrast agent in septal cysts.Cyst sclerotherapy was performed for simple cysts and simple septal cysts,surgical treatment was performed for thick walled cysts,and follow-up observation was performed for ductal ectasia.Results:Among the 45 patients,20 cases were simple cysts and 25 cases were complex cysts.Among the complex cysts,19 cases were septal cysts(including 3 cases of ductal ectasia,16 cases of simple septal cysts)and 6 cases of thick-walled cysts(4 cases of intraductal papilloma,1 case of intraductal papillary carcinoma and 1 case of invasive ductal carcinoma).Thirty-six cases of cysts underwent sclerotherapy,6 cases underwent surgical resection and 3 cases of ductal ectasia were followed up.Conclusion:Contrast-enhanced ultrasound can accurately evaluate the classification of cysts and has important clinical value in guiding the treatment of breast cysts.