乳腺癌不同病灶大小、病理类型及组织学分级的超声造影差异  

Contrast-enhanced ultrasonic discrepancy of different lesion size, pathological type and histological grading in breast cancer

作　　者：冷晓玲[1] 黄国福[2] 马富成[1] 

机构地区：[1]新疆医科大学附属肿瘤医院超声科,新疆乌鲁木齐830011 [2]新疆医科大学第五附属医院放化疗科,新疆乌鲁木齐830011

出　　处：《中国临床医学影像杂志》2015年第8期561-565,共5页Journal of China Clinic Medical Imaging

基　　金：国家自然科学基金项目(81260332)

摘　　要：目的:探讨不同病灶大小、病理类型及组织学分级的乳腺癌超声造影特点是否有差异。方法 :回顾性分析113例乳腺癌患者119个病灶的超声造影灌注模式,分析所有病例病变区域的超声造影增强特点及模式,包括增强范围是否大于二维超声显示、增强强度、造影剂分布情况、造影剂进入肿瘤顺序、造影模式、是否有穿支血管、是否有灌注缺损等指标,术后收集乳腺癌大小、病理类型并分析组织学分级,分析其超声造影特征与病灶大小、病理类型、组织学分级的关系。结果:≤2 cm的乳腺癌更倾向于低增强或等增强,无灌注缺损及穿支血管;>2 cm的乳腺癌倾向于高增强、存在灌注缺损及穿支血管等造影特征(P<0.05)。但超声造影增强范围是否大于二维超声、造影剂分布特点、造影剂进入肿瘤的顺序、造影模式的差异与病灶大小无关(P>0.05)。乳腺癌组织学分级Ⅲ级肿块出现造影后高增强、周边增强、速升缓降的比率高于组织学Ⅰ、Ⅱ级肿块(P<0.05),而超声造影的增强范围、造影剂进入肿瘤的顺序、是否有灌注缺损、是否有穿支血管在乳腺癌不同组织学分级间无差异(P>0.05)。结论:病灶大小和组织学分级对超声造影特征的影响要强于肿瘤病理类型,乳腺癌超声造影的表现与肿瘤大小及组织学分级的变化密切相关,乳腺癌的超声造影特点对组织学分级有一定提示作用。Objective： To explore the differences of enhanced ultrasound features of the different lesion size, pathological type and histological grading of breast cancer. Methods： Contrast-enhanced ultrasound perfusion modes were analyzed retrospectively in 113 cases of breast cancer patients with 119 lesions. The ultrasonic contrast enhancement characteristics, including enhanced range, enhanced strength, contrast agent distribution, entering sequence, contrast mode, the perforator vessel and perfusion defects etc. were also analyzed. Postoperative pathological types and size, histological grade in breast cancer tissue were collected. To analyze the relationship between contrast-enhanced uhrasonography and lesion size, pathological type, histological grading. Results： Lesions less than 2 cm were more inclined to mild enhancement or moderate enhancement, without blood flow perfusion defect and without perforator; breast cancer lesions more than 2 cm were more inclined to marked enhancement, the existence of perfusion defects and perforator（P〈0.05）. But whether the range of lesions detected by contrast enhanced ultrasound range is greater than the two-dimensional uhrasound or not, contrast agent distribution characteristics, entry order of contrast agent, imaging sequence model differences were unrelated to lesion size （P〉0.05）. After contrast enhancement, the ratio of peripheral enhancement, high strength reinforced, peripheral enhancement, speed up and slow down in breast cancer lesions with histological grade Ⅲlevel was higher than that of histological grade Ⅰ or Ⅱ tumor （P〈0.05）. There were no differences in enhanced range, contrast agent entry order, perfusion defects and perforator vessel between the different histological grade of breast cancer（P〉0.05）. Conclusion： Effect of lesion size and histological grading on contrast enhanced ultrasound features was stronger than the tumor pathological type. Contrast enhanced ultrasound of breast cancer may play a certain role of histologic

关 键 词：乳腺肿瘤 超声检查 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]