浸润性导管癌的实时灰阶超声造影研究  

Contrast-enhanced Ultrasonographic Findings of Breast Invasive Ductal Carcinoma

作　　者：胡蓉菲[1] 许萍[2] 汪晓虹[2] 王怡[2] 童玲[1] 

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

出　　处：《中国医学计算机成像杂志》2011年第4期365-368,共4页Chinese Computed Medical Imaging

摘　　要：目的:分析乳腺浸润性导管癌的实时灰阶超声造影特征及诊断价值。方法:回顾性分析67例浸润性导管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:67个浸润性导管癌中,造影增强显示病灶形态不规则49个(73%),边界不清51个(76%),周边穿入或扭曲血管50个(75%),内部对比剂分布不均匀58个(87%),其中可见局灶性充盈缺损21个(31%)。超声造影增强前、后病灶的平均大小分别为(23.3±9.9)mm(、26.1±9.5)mm,造影后肿块明显增大(P<0.01)。对比剂到达时间、达峰时间、峰值强度的平均值分别为(11.9±4.5)s(、20.1±4.6)s、4.9±2.8。本组浸润性导管癌超声造影的诊断准确率为82%(55/67),低于常规超声的诊断率91%(61/67)。结论:乳腺浸润性导管癌大多具有典型的恶性造影增强特征,但部分呈低增强模式而易导致误诊,超声造影较常规超声未能进一步提高其诊断准确率。Purpose： To evaluate the imaging characteristics and the value of real - time gray scale contrast - enhanced ultrasonography（CEUS） in the diagnosis of breast invasive ductal carcinoma（IDC） . Methods： We retrospectively reviewed the contrast - enhanced sonographic findings of all the 67 IDCs confirmed by histopathology, including morphologic features and quantitative parameters. Diagnostic accuracy was then compared between CEUS and conventional ultrasonography（US） . Results： The 67 IDCs displayed irregular shape [ 49 （ 73 % ） ], poorly defined margin [ 51 （ 76 % ） ], penetrating or tortuous surrounding vessels [50（75%）], heterogeneous enhancement[58（87%）] and perfusion defects [21（31%）] on CEUS. The size measurement of all the 67 lesions was obviously increased on CEUS （23.3 ± 9.9ram vs 26.1 ± 9.5ram, precontrast vs postcontrast） （P 〈 0.01）. The mean arrival time, time to peak, peak intensity were 11.9 ± 4.5s, 20.1 ± 4.6s, 4.9 ± 2.8 respectively. In the group of IDCs, the diagnostic accuracy of CEUS was 82 % （ 55/67）, which was lower than conventional US [ 91% （ 61/67） ] . Conclusion： Most of IDCs can exhibit typical characteristics of malignant tumor on CEUS, but some of them might be misdiagnosed due to the hypoenhancement pattern. The diagnostic performance is not obviously improved by CEUS, comparing to conventional US.

关 键 词：超声检查 对比剂 乳腺肿瘤 浸润性导管癌 

分 类 号：R737.9[医药卫生—肿瘤]