超声造影微血管成像对乳腺良恶性肿瘤微血管构筑的评价  

Evaluation on Angiogenesis of Benign and Malignant Breast Tumors with Contrast Enhanced Microvascular Imaging

作　　者：李颖嘉[1] 张云昆[2] 周晏梅[2] 

机构地区：[1]南方医科大学南方医院超声科,广州市510515 [2]南方医科大学南方医院查体中心,广州市510515

出　　处：《中国超声医学杂志》2009年第6期559-563,共5页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金资助面上项目（No.30670580）

摘　　要：目的探讨乳腺良恶性肿瘤微血管构筑变化特征。方法应用超声造影微血管成像（MVI）技术检测30例（33个病灶）乳腺恶性肿瘤、30例（34个病灶）乳腺纤维腺瘤微血管构筑变化特征,光、电镜观察瘤内新生血管显微结构及超微结构改变,免疫组化技术检测瘤内微血管密度（MVD）。结果造影后不均匀增强,充盈缺损,紊乱的血管网、血管扩张、血管迂曲征象在良恶性肿瘤有显著性差异（P〈0.05）。光镜下90.91%（30/33）乳腺恶性肿瘤中见坏死灶,间质中见弥漫分布粗细不均的新生血管,异常扩张的大血管和裂隙状的新生血管并存。乳腺纤维腺瘤均未见坏死灶,血管管径和分布均一。透射电镜下恶性组新生血管内皮细胞超微结构具有不同于正常血管内皮细胞的瘤性特征。恶性组MVD显著高于良性组（P〈0.05）。结论实时超声造影MVI可以反映肿瘤血管的解剖和生理特征,造影后灌注模式的差异为乳腺良恶性肿瘤的鉴别诊断提供了重要依据。Objective To compare the differences in angiogenesis characteristics between benign and malignant tumor. Methods 30 cases with malignant breast carcinoma and 30 cases with fibroadenoma were inspected by contrast enhanced microvascular imaging （MVI） . All samples were analysed with microscopy by HE staining. The samples of breast cancers （6 cases）, breast fibroadenoma （4 cases） and normal breast tissues （4 cases） were analysed routinely with transmission electron microscopy. The expression of CD34 in both two groups were measured with immuhisto- chemical technique. Results MVI inside of the focus was increased heterogeneously that had the characteristic of ma- lignant tumor such as filling defect and vessel distortion. The newborn blood vessels of breast cancer were composed of monolayer endothelial cells, the gap between endothelial cells became wide. The basement membrane not continuously had obvious interstitial edema. The shapes of endothelial cells were abnormal, the cell body became bigger and cyto- plasm became richer and abnormal cell nucleus appeared and pinocytotic vesicle increased. The distribution of CD34 in breast carcinoma was heterogeneous. The micro-vessels densely distributed and diffused around themargin of cancer nest. The MVD of malignant group （34. 48± 8.34） was significantly higher than that of benign group （18.65 ± 4.69）. Conclusions The perfusion pattern are valuable diagnostic basis in discriminating benign and malignant breast tumor.

关 键 词：超声造影微血管成像 乳腺良恶性肿瘤 微血管 治疗 临床 造影剂 

分 类 号：R445.7[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]