乳腺病变超声造影与磁共振增强方式的对比研究  

Enhancement characterization of breast masses of contrast-enhanced ultrasound： comparison with MRI

作　　者：李小康[1] 朱鹰[1] 刘佩芳[1] 徐熠琳[1] 邵真真[1] 

机构地区：[1]天津医科大学肿瘤医院乳腺影像诊断科国家肿瘤临床医学研究中心天津市"肿瘤防治"重点实验室乳腺癌防治教育部重点实验室,300060

出　　处：《中华超声影像学杂志》2014年第1期44-48,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨乳腺病变超声造影与磁共振（MRI）增强方式的表现特点及异同。方法搜集自2011年8月至2013年3月期间同时行超声造影与MRI检查的72例患者资料，选取72个病灶，所有病例均经手术或超声引导下穿刺活检病理证实。对比分析时选取与超声造影图像增强形态、大小相似的MRI切面，图像分析包括：增强均匀性（均匀、不均匀）、增强后病变面积、灌注缺损面积、时间一强度曲线类型。对二者评估的相关性、差异及一致性进行统计学分析。结果72个乳腺病灶中，组织病理学结果为恶性病变56个（77．8％），良性病变16个（22．2％）。超声造影与MRI对72例乳腺病变增强后面积的评估具有良好的一致性（P=0．000），经配对t检验二者差异无统计学意义（P=0．886）。超声造影与MRI对乳腺病变增强均匀性的评价不完全一致（Kappa=-0．153，P=0．061），超声造影较MRI更多表现为不均匀增强（分别为34例和23例），且超声造影灌注缺损面积[（0．837±0．827）cm2]大于MRI同切面灌注缺损面积Uo．576±0．524）crll。]，经配对t检验二者差异有统计学意义（P=0．01）。二者时间一强度曲线类型无明显相关性。结论尽管超声造影与增强MRI在乳腺病变的增强方式上部分存在相同的表现，但二者增强方式之间缺乏直接联系，对比增强原理的区别使其在基础研究及临床应用中各具特点。Objective To assess the enhancement characteristic of breast lesions of contrast-enhanced ultrasound （CEUS） in comparison with contrast-enhanced magnetic resonance imaging （MRI）. Methods Between August 2011 and March 2013,72 women with 72 lesions were enrolled. All patients underwent ultrasound,CEUS and MRI. The histopathologic results obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard. CEUS section evaluations were made similar with MRI regarding the size and shape of lesions. Different contrast enhancement patterns including homogeneous/heterogeneous,the tumor areas, the perfusion defect areas, and modality of time-intensity curve were evaluated. Pearson＇s correlation coefficient,Student＇s t-tests,and the concordance test were used for evaluation. Results Of the 72 lesions, pathologic examination revealed 56 （77.8%） malignant lesions and 16 （22.2%） benign lesions. The tumor areas measured by CEUS and MRI agreed well, with a correlation of r = 0.894, P = 0. 000. The difference between the two measurements was not significant according to a paired t test（ P = 0. 886）. The concordance tests gave a value of the coefficient Kappa = -0. 153 （P = 0.061）, indicating a low concordance between the results obtained with CEUS and those obtained with MRI regarding the enhanced uniformity. There were statistically significant differences in the perfusion defect areas as measured by CEUS and MRI （ P = 0.01）. The CEUS estimates E（0. 837 ± 0. 827） cm2] were consistently higher than the MRI estimates [（0. 576 ± 0. 524）cm2]. The time-intensity curve patterns between the two groups showed no correlation. Conclusions The enhancement patterns evaluated by CEUS and MRI partly agreed well. There was no direct association between the two methods regarding the enhancement patterns because of the different contrast agent.

关 键 词：超声检查 微气泡 乳腺肿瘤 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]