超声造影联合弹性成像在乳腺良恶性结节鉴别诊断中的应用价值  

Ultrasonic Elastography Combined with Contrast-enhanced Ultrasound in Differential Dignosis for Benign and Malignant Breast Nodules

作　　者：茹融融 徐栋[1] 邱俐 姚春[1] 汪琴娟 张亦青 富威东 

机构地区：[1]浙江萧山医院,浙江萧山311202

出　　处：《肿瘤学杂志》2013年第9期680-684,共5页Journal of Chinese Oncology

基　　金：杭州市科技发展计划项目(20110833B45);杭州市萧山区科技计划项目(2011329)

摘　　要：[目的]评价超声造影联合弹性成像在乳腺良恶性结节鉴别诊断中的应用价值。[方法]对151个经手术病理证实的乳腺良恶性结节的超声造影和弹性成像特征进行对比分析,评估各诊断方法的敏感性、特异性及准确性。[结果]151个乳腺结节中,良性病灶110个,恶性病灶41个。在注射造影剂后良性结节多呈点状、线状和结节状增强,增强边界多平滑;恶性结节则大多以不均匀、高增强为主,且增强边界多数欠清或不清。良性结节的时间—强度曲线呈"缓升速降"或"速升速降"型;恶性结节呈"速升缓降"型。超声造影的敏感性、特异性及准确性分别为65.9%、94.5%、86.8%。弹性成像的敏感性、特异性及准确度分别为61.0%、91.8%、77.5%。超声造影联合弹性成像的敏感性、特异性及准确性分别为87.8%、95.5%、93.4%。[结论]超声造影联合弹性成像对乳腺良恶性结节的鉴别有较高的应用价值,可提高该病的诊断率。[Purpose] To assess the value of contrast-enhanced ultrasound（CEUS） combined with ultrasonic elastography in differential dignosis for benign and malignant breast nodules.[Meth- ods] CEUS and ultrasonic elastography characteristics benign and malignant breast nodules pathologically proved were analyzed. The sensitivity,specificity and accuracy were evaluated. [Results! In 151 cases with breast nodules, 110 cases were benign breast nodules and 41 cases were malignant breast nodules. After injection of contrast agent,benign breast nodules mostly showed punctual,linear or nodular enhancement with smooth boarder while malignant breast nodules mainly showed uneven or high enhancement with indistinct boarder. The time-intensity curve for benign breast nodules was ＂slow rise and fast fall＂ or ＂fast rise and fast fall＂ while ＂fast rise and slow fall＂ for malignant breast nodules. The sensitivity, specificity and accuracy of C EUS were 65.9%, 94.5%, 86.8%, those of ultrasonic elastography were 61.0%, 91.8%, 77.5%, and of CEUS combined with ultrasonic elastography were 87.8%, 95.5%,93.4% respectively. [Conclusionsl The combination of CEUS and ultrasonic elastography has high value in differ- ential diagnosis for benign and malignant breast nodules, improves the diagnostic accuracy.

关 键 词：乳腺结节 弹性成像 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学]