超声造影在指导乳腺癌穿刺活检中的价值  

The value of contrast enhanced ultrasound in breast cancer biopsy

作　　者：席丽丽[1] 陈亚青[1] 蒋珺[1] 朱云开[1] 管雯斌[2] 屈月红[1] 王立峰[2] Xi Lili;Chen Yaqing;Jiang Jun;Zhu Yunkai;Guan Wenbin;Qu Yuehong;Wang Lifeng(Department of Ultrasound in Medicine,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China;Department of Pathology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院超声科,200092 [2]上海交通大学医学院附属新华医院病理科,200092

出　　处：《中华超声影像学杂志》2019年第9期782-786,共5页Chinese Journal of Ultrasonography

摘　　要：目的研究超声造影技术在指导乳腺癌穿刺活检中的作用。方法回顾性分析49例行乳腺穿刺活检并经病理证实为乳腺癌的患者。所有患者在穿刺前行超声造影检查,随后在超声引导下分别对肿块高增强区域及低/无增强区域进行穿刺活检,通过与穿刺病理对照,比较高增强区域及低/无增强区域的病理诊断确诊率及穿刺标本的肿瘤百分比。结果49例患者共穿刺证实53个乳腺癌病灶。穿刺前超声造影表现为均匀增强病灶8个(15.1%,8/53),不均匀增强病灶45个(84.9%,45/53)。针对高增强区域穿刺的病理确诊率显著高于低/无增强区域(98.5%对72.9%,P<0.01)。此外,高增强区穿刺取得的肿瘤组织所占百分比亦明显高于低/无增强区域(55%对30%,P<0.01)。结论超声造影技术能通过对肿瘤微血管的显示鉴别乳腺肿瘤的活性区域及坏死纤维化区域,从而有助于穿刺部位的选择,提高穿刺准确性。Objective To retrospectively investigate the value of contrast enhanced ultrasound (CEUS) in breast cancer biopsy. Methods A total of 49 consecutive patients with biopsy confirmed breast cancer were retrospectively analyzed. All patients underwent CEUS and biopsies were thus performed targeting both the high perfusion and low/non-perfusion regions on CEUS. The diagnostic performance and core cancer involvement of the biopsy cores taken from the high perfusion regions were compared with those from the low/non-perfusion. Results A total of 53 breast cancer lesions were biopsy confirmed in 49 patients.CEUS revealed homogeneous enhancement in 8 lesions (15.1%), and heterogeneous enhancement in 45 lesions (84.9%). The diagnostic accuracy rate for biopsy cores taken from the high perfusion regions was significantly higher than that from the low/non-perfusion regions (98.5% vs 72.9%, P<0.01). The core cancer involvement was also higher in high perfusion lesions (55% vs 30%, P<0.01). Conclusions CEUS can differentiate the active area and necrotic fibrosis area of breast tumors by displaying the microvessels, thus contributing to the selection of biopsy sites.

关 键 词：超声造影 乳腺肿瘤 活组织检查 针吸 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]