实时灰阶超声造影在乳腺导管原位癌诊断中的初步评价  

Breast Ductal Carcinoma in Situ:Imaging with Contrast-enhanced Ultrasonography-lnitial Experience

作　　者：许萍[1] 王怡[1] 胡蓉菲[2] 汪晓虹[1] 富丽娜[1] 

机构地区：[1]复旦大学附属华山医院超声医学科,上海市200040 [2]复旦大学附属华山医院宝山分院超声科

出　　处：《中国超声医学杂志》2011年第2期119-122,共4页Chinese Journal of Ultrasound in Medicine

基　　金：上海市浦东新区科技发展基金创新资金(No:PKJ2008-Y04)

摘　　要：目的评价超声造影对乳腺导管原位癌的诊断价值。方法回顾性分析17个乳腺导管原位癌的超声造影形态学增强模式和时间-强度曲线定量参数,并比较常规超声和超声造影对该组肿瘤的诊断准确率。结果本组17个导管原位癌中,造影增强显示病灶周围扭曲或穿入血管15个(88.2%)、造影剂分布不均匀16个(94.1%)、病灶形态不规则14个(82.4%)。超声造影前后肿块的平均大小分别为(27.0±9.4)mm、(31.6±11.8)mm,造影后肿块明显增大(P<0.01)。病灶多呈快速高增强,平均达峰时间(1 7.3±3.9)s、平均峰值强度6.8±2.8。本组乳腺导管原位癌超声造影的诊断准确率达94%(16/17)。结论乳腺导管原位癌具有较典型的恶性造影增强特征。超声造影明显提高了对导管原位癌的诊断准确率,有望成为提高乳腺癌早期诊断率的一个重要手段。Objective To assess the value of real time gray scale contrast-enhanced ultrasonography （CEUS） in the diagnosis of breast ductal carcinoma in situ （DCIS）. Methods We retrospectively reviewed the contrast-enhanced sonographic findings of all the 17 DCIS histopathologically confirmed,including morphologic features and quantitative parameters. Diagnostic accuracy was then compared between CEUS and conventional uhrasonography（US）. Results The 17 DCISs displayed penetrating or tortuous surrounding vessels [ 15 （88.2%）], heterogeneous enhancement[16 （94.1% ）], irregular shape[14（82.4 % ）]on CEUS. The size measurement of all the 17 lesions obviously increased on CEUS （27.0±9.4 mm vs 31.6±11.8 mm,preeontrast vs posteontrast）（P〈0.01）. The lesions showed quick hyperenhancement on CEUS. Mean peak intensity was 6.8±2.8 and mean time to peak was 17.3±3.9s. DCIS achieved an improved diagnostic accuracy of 94 % （16/17）. Conclusions DCIS can exhibit typical characteristics of malignant tumor on CEUS. CEUS has the potential of becoming an effective method to improve the accuracy in the diagnosis of the early breast cancer.

关 键 词：超声检查 造影剂 乳腺肿瘤 导管原位癌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]