乳腺癌患者超声造影表现及其与微血管密度的关系  

Study on the correlation between contrast-enhanced ultrasonographic characteristics and microvessel density in breast cancer

作　　者：曹小丽[1] 刘瑞华[1] 刘美娟[1] 曹立萍[1] 王丽红[1] 张玉莲[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院超声科,264000

出　　处：《中华医学超声杂志（电子版）》2013年第7期590-595,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨乳腺癌患者超声造影表现及其与微血管密度(MVD)的关系。方法对2010年10月至2012年2月青岛大学医学院附属烟台毓璜顶医院45例乳腺癌患者45个肿瘤术前行超声造影检查,利用时间-强度曲线得到乳腺癌肿瘤中心区域、肿瘤边缘区域、肿瘤周围正常乳腺组织血流灌注参数上升时间(RT)、峰值强度(PI)、达峰时间(TTP)、流入斜率(WIS)以及平均渡越时间(MTT)并进行比较;同时将术后病理标本行抗CD34因子免疫组化染色,检测肿瘤MVD;比较不同MVD乳腺癌超声造影增强表现和血流灌注参数。结果 45个乳腺癌MVD平均(47.6±14.2)个/高倍视野,其中高MVD组(MVD>48个/高倍视野)21个(46.7%),低MVD组(MVD≤48个/高倍视野)24个(53.3%)。45个乳腺癌超声造影后除2个(4.4%)无增强外,其余43个(95.6%)均出现不同程度增强。其中25个(55.6%)不均匀增强,27个(60.0%)有血流灌注缺损;37个(82.2%)增强形态不规则;25个(55.6%)向心性增强;32个(71.1%)有穿支血管;34个(75.6%)增强边界不清晰。乳腺癌肿瘤中心区域与肿瘤周围正常乳腺组织相比,RT、TTP均缩短[(9.3±3.3)svs(11.1±3.7)s,(25.3±5.9)svs(27.5±6.4)s],PI增高[(12.1±4.6)dBvs(9.2±2.8)dB],WIS增大(1.0±0.4vs0.8±0.3),且差异均有统计学意义(t值分别为-3.001、-4.785、6.987、5.438,P均<0.05);肿瘤边缘区域与肿瘤中心区域相比,TTP缩短[(22.2±6.0)svs(25.3±5.9)s],PI增高[(15.4±5.1)dBvs(12.1±4.6)dB],WIS增大(1.3±0.5vs1.0±0.4),且差异亦均有统计学意义(t值分别为-2.839、3.194、3.151,P均<0.05)。高MVD组乳腺癌不均匀增强、血流灌注缺损发生率均高于低MVD组乳腺癌,且差异均有统计学意义(χ2值分别为4.0179、7.2024,P均<0.05);两组肿瘤增强形态、增强边界及穿支血管差异无统计学意义。高MVD乳腺癌PI高于低MVD组乳腺癌[(18.2±5.6)dBvs(12.9±3.1)dB],且差异有统计学意义(t=-3.738,P<0.05);而2组RT、TTP及WIS差异无统计学意义。结论乳腺癌超声�Objective To investigate the relation of contrast-enhanced ultrasound ( CEUS ) characteristics and microvessel density ( MVD ) in the breast cancer .Methods From October 2010 to February 2012, 45 cases of patients with breast cancer were studied in Yantai Yuhuangding Hospital , Affiliated to Qingdao University Medical College .All lesions were examined by CEUS before surgery .The blood perfusion parameters such as rising time (RT),peak intensity(PI),time to peak(TTP),wash-in slope (WIS) and mean transit time ( MTT) were obtained by time-intensity curve ( TIC).Immunohistochemical staining for anti-factor CD34 was performed on surgery specimen and the MVD was evaluated .The CEUS characteristics and blood perfusion parameters between different MVD groups of breast cancer were compared.Results In 45 cases of breast cancer,mean MVD was(47.6 ±14.2)/high power field(HPD). Twenty-one cases(46.7%) were classified as high MVD group(MVD>48/HPD) and 24 cases(53.3%)&nbsp;were classified as lower MVD group ( MVD≤48/HPD) .Besides two cases without contrast agent perfusion in CEUS imaging, blood perfusion was observed in 43 cases (95.6%).Heterogeneous enhancement was observed in 25 cases(55.6%).Local blood perfusion defect was observed in 27 cases(60.0%).Irregular shape was observed in 37 cases(82.2%).Centripetal enhancement was observed in 25 cases(55.6%). Penetrating surrounding vessels was observed in 32 cases(71.1%).Poorly-defined margin was observed in 34 cases(75.6%).Compared with the surrounding normal breast tissue ,RT and TTP of center region of neoplasms was shorter[(9.3 ±3.3)s vs (11.1 ±3.7)s and (25.3 ±5.9)s vs (27.5 ±6.4)s],PI was higher[(12.1 ±4.6)dB vs (9.2 ±2.8)dB],WIS was higher(1.0 ±0.4 vs 0.8 ±0.3) and differences were significant(t =-3.001, -4.785,6.987 and 5.438,all P <0.05).Compared with center region of neoplasms,TTP of periphery region of neoplasms was shorter [(22.2 ±6.0)s vs (25.3 ±5.9)s],PI was higher[(15.4 ±5.1)dB vs (12.1 ±4.6)dB],WIS was larger(1.3 ±0.5 vs 1.0 ±0.4) and differences

关 键 词：超声检查 造影剂 乳腺肿瘤 微血管密度 

分 类 号：R737.9[医药卫生—肿瘤]