实时超声造影鉴别诊断长径≤2.0cm乳腺肿块良恶性  

Real-time contrast-enhanced ultrasound in differential diagnosis of benign and malignant breast tumors with the length-diameter no more than 2.0cm

作　　者：李由[1] 郭燕丽[1] 黄海韵[1] 陈萍[1] 陈凯旋[1] 

机构地区：[1]第三军医大学西南医院超声科,重庆400038

出　　处：《中国医学影像技术》2014年第12期1848-1852,共5页Chinese Journal of Medical Imaging Technology

基　　金：重庆市自然科学基金重点项目(cstc2012jjB10072)

摘　　要：目的探讨应用实时超声造影(RT-CEUS)灌注特征和时间-强度曲线定量参数鉴别诊断长径≤2.0cm乳腺良恶性肿块的价值。方法回顾性分析63例乳腺肿块患者(良性30例,恶性33例)的常规CDFI及RT-CEUS影像资料,对比良恶性乳腺肿块的造影特点及时间-强度曲线定量参数差异,并评价诊断效能。结果恶性肿块超声造影多表现为向心性、不均匀、高增强,周边呈放射状,87.88%(29/33)边界模糊;良性肿块多表现为离心性、均匀、低增强,83.33%(25/30)边界清晰。78.79%(26/33)的恶性肿块造影后内部可见灌注缺损。定量分析显示,恶性肿块的峰值强度(PI)及时间-强度曲线上升支斜率(k)均高于良性肿块(P均<0.05),达峰时间(TP)差异无统计学意义(P>0.05)。单纯应用常规CDFI诊断长径≤2.0cm的乳腺恶性肿块的敏感度为72.73%(24/33),特异度为73.33%(22/30),诊断准确率为73.02%(46/63);CDFI结合超声造影灌注情况的诊断敏感度为81.82%(27/33),特异度为83.33%(25/30),准确率为82.54%(52/63)。结论 RT-CEUS灌注图像特征结合时间-强度曲线定量指标有助于提高鉴别诊断长径≤2.0cm乳腺良恶性肿块的准确性。Objective To investigate the perfusion characteristics and quantitative parameters of time-intensity curve（TIC）in diagnosis of benign and malignant breast tumors（length-diameter≤2.0cm）using real-time contrast-enhanced ultrasound（RT-CEUS）.Methods Color doppler flow imaging（CDFI）and CEUS data of patients with breast masses,including 33 cases of malignant tumors and 30 cases of benign tumors were retrospectively studied.Difference of TIC quantitative parameters between benign and malignant breast tumors were compared.And the diagnostic efficiency was evaluated.Results Characteristics of concentric,inhomogeneous,high perfusion and radiate boundary were found in majority of malignant tumors.The boundary of 87.88%（29/33）malignant tumors was fuzzy.While centrifugal,homogeneous and low perfusion were found in benign tumors.The boundary of 83.33%（25/30）benign tumors was clear.Perfusion defect was found in 78.79%（26/33）malignant tumors.Quantitative analysis：Compared with benign tumors,peak intensity（PI）and the slope of TIC ascending branch（k）were higher in malignant tumors（both P〈0.05）.No statistical difference was found of time of peak（TP）between benign and malignant tumors（P〉0.05）.The sensitivity,specificity and accuracy of CDFI in diagnosing malignant breast tumors with length-diameter≤2.0cm was 72.73%（24/33）,73.33%（22/30）and73.02%（46/63）,respectively.And the sensitivity,specificity and accuracy of CDFI combined CEUS was separately81.82%（27/33）,83.33%（25/30）and 82.54%（52/63）.Conclusion RT-CEUS perfusion characteristics and TIC quantitative parameters are helpful to increase diagnostic accuracy of breast tumors with length-diameter≤2.0cm.

关 键 词：超声检查 时间-强度曲线 乳腺肿瘤 诊断 鉴别 

分 类 号：R445.1[医药卫生—影像医学与核医学] R730.41[医药卫生—诊断学]