南方医科大学学报 ›› 2013, Vol. 33 ›› Issue (12): 1801-.

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超声造影在乳腺癌早期诊断中的临床应用

蔡丽珊,张建兴,宋光辉,陈铃,戴九龙   

  • 出版日期:2013-12-20 发布日期:2013-12-20

Value of contrast-enhanced sonography in early diagnosis of breast cancer

  • Online:2013-12-20 Published:2013-12-20

摘要: 目的探讨超声造影在乳腺癌早期鉴别诊断中的临床应用价值。方法107例超声BI-RADS®分类3或4类的乳腺小肿块
(直径小于等于10 mm)术前行超声造影检查,观察肿块及其周边在超声造影全程中的强化范围、强化类型、强化方式,并应用时
间一强度曲线(TIC)分析TIC曲线类型、肿块增强模式、基础强度、峰值强度、强化强度、上升斜率、强化强度指数以及曲线类型,
分析上述结果在良恶性肿块间的差异。结果乳腺良恶性肿块的超声造影峰值强度、增强强度指数以及峰值时间差异有统计学
意义(t=-2.310、-2.592、-2.127,P=0.021、0.010、0.033);强度差值及上升斜率差异有统计学意义(t=-3.422、-3.388,P=0.001、
0.001)。乳腺良恶性肿块的超声造影TIC 曲线类型、强化方式、强化类型以及强化范围差异有统计学意义(P<0.001)。结论超
声BI-RADS®分类3或4类且病灶直径小于等于10 mm的乳腺良恶性肿瘤超声造影在TIC曲线上差异主要表现在超声造影峰
值强度、增强强度指数以及峰值时间等方面。更多乳腺增生结节超声造影表现为无明显强化,97.8%的无强化病例为乳腺良性
病变。有强化的乳腺结节中,乳腺恶性病变更多的表现为快进快出型和快进慢出型,其中以快进慢出型多见;而良性病变更多
表现为慢进慢出型。乳腺恶性结节较多表现为强化范围大于二维范围。

Abstract: Objective To assess the clinical value of contrast-enhanced ultrasonography (CEUS) in early diagnosis of breast
cancer. Methods CEUS was performed in 107 cases of ultrasound BI-RADS® category 3 or category 4 small breast tumors
(diameter no greater than 10 mm) before surgery. The range, type and patter of enhancement of the tumor and the
surrounding tissues were observed, and the time-intensity curve (TIC) was analyzed for TIC curve type, basic and peak
intensity, enhancement intensity, rising slope, and enhancement intensity. The results were analyzed comparatively between
benign and malignant tumors. Results The peak intensity, enhancement intensity index and peak time in CEUS were
statistically significant between benign and malignant breast tumor (t=-2.310, -2.592, -2.127, P=0.021, 0.010, 0.033), and the
intensity difference and rising slope also differed significantly (t=-3.422, -3.388, P=0.001, 0.001). TIC curve type, enhancement
pattern, enhancement types and enhancement range were statistically significantly between benign and malignant breast
tumor (P<0.001). Conclusion Benign and malignant BI-RADS® category 3 or 4 small breast tumors differ in the peak intensity,
enhancement intensity index and peak time in CEUS. More nodular hyperplasia showed no enhancement in CEUS, and 97.8%
of the lesions without enhancement are benign. In enhanced breast nodules, malignant breast lesions show more quick
wash-in and wash-out type and quick wash-in and slow wash-out type, and the latter is more common; benign lesions often
show a slow wash-in and slow wash-out type. In CEUS, the range of enhancement in malignant nodules is wider than that in
two-dimensional ultrasound.