灰阶超声造影结合MRI:重新认识乳腺肿瘤生长方位  

Gray-scale contrast-enhanced ultrasonography combined with MRI:Re-recognization of growth orientation of breast masses

作　　者：昝星有 李明 周卫平 刘明芃 李娜 吴鹏西 方向明 ZAN Xingyou;LI Ming;ZHOU Weiping;LIU Mingpeng;LI Na;WU Pengxi;FANG Xiangming(Department of Medical Ultrasound,Wuxi People's Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China;Department of Medical Imaging,Wuxi People's Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡人民医院超声医学科,江苏无锡214023 [2]南京医科大学附属无锡人民医院医学影像科,江苏无锡214023

出　　处：《中国医学影像技术》2020年第1期81-85,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金面上项目(81271629)

摘　　要：目的采用超声造影(CEUS)结合MRI观察乳腺肿瘤生长方位。方法收集103例接受检查和治疗的乳腺肿瘤患者,包括良性肿瘤35例(良性组)、恶性肿瘤68例(恶性组),常规超声(CUS)显示为非平行位生长,观察同切面CEUS显示的肿瘤生长方位;对其中20例行MR检查,观察肿瘤与邻近皮肤的关系,并与CEUS显示的肿瘤方位进行比较。结果CEUS后,良性组4例生长方位改变,31例无改变;恶性组59例生长方位改变,9例无改变(χ2=55.210,P<0.001)。以病理结果为金标准,根据CEUS生长方位改变诊断乳腺良恶性肿瘤的敏感度为93.65%(59/63),特异度77.50%(31/40),阳性预测值86.76%(59/68),阴性预测值88.57%(31/35)。MRI显示19例乳腺癌生长方位与CEUS一致(P=0.500)。CEUS判定肿瘤方位与MRI一致性良好(Kappa=0.828)。结论CUS显示非平行位生长乳腺良性肿瘤多与CEUS一致,而乳腺恶性肿瘤CEUS后多表现为平行位生长。CEUS与MRI显示肿瘤生长方位一致性良好。CEUS判定乳腺肿瘤生长方位较CUS更可靠。Objective To observe growth orientation of breast masses with contrast-enhanced ultrasonography(CEUS)combined with breast MRI.Methods A total of 103 patients with conventional ultrasound(CUS)showed non-parallel-orientation growth breast masses were enrolled and divided into benign group(n=35)and malignant group(n=68).Tumor growth orientation shown with CEUS was observed in the same section.Twenty patients underwent MRI,the relationships between mass and adjacent skin were observed and compared with mass location shown on CEUS.Results After CEUS,growth orientation was changed in 4 cases but not in 31 cases of benign group,while in malignant group,changes of tumor growth orientation was noticed in 59 cases but not in 9 cases,indicating that the growth orientation of malignant tumor was more easily to change than benign ones(χ2=55.210,P<0.001).The sensitivity,specificity,positive predictive value and negative predictive value of CEUS in diagnosis of benign and malignant breast masses was 93.65%(59/63),77.50%(31/40),86.76%(59/68)and 88.57%(31/35),respectively.MRI showed consistent results with CEUS for growth orientation in 19 cases(P=0.500).CEUS was consistent with MRI in determination of tumor location(Kappa=0.828).Conclusion Among breast masses CUS showed non-parallel position,most benign ones had some founding in CEUS,but most malignant breast masses showed parallel growth in CEUS.CEUS has good consistency with MRI in determining the orientation of breast masses,which is more reliable than CUS in evaluation on the growth location of breast tumors.

关 键 词：乳腺肿瘤 超声检查 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445[医药卫生—临床医学]