常规超声分型和超声造影在乳腺非肿块型病变中的应用价值  

Application Value of Conventional Ultrasound Classification and Contrast-Enhanced Ultrasound in Non-Mass Breast-Like Lesions

作　　者：池月芮 刘丽[3] 刘喜艳 刘静[2] 刘勋[2] 徐文贵 CHI Yuerui;LIU Li;LIU Xiyan;LIU Jing;LIU Xun;XU Wengui(Department of Molecular Imaging and Nuclear Medicine,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin,Tianjin’s Clinical Research Center for Cancer,Tianjin 300060,China;Department of Ultrasonography,The Fifth Central Hospital of Tianjin,Tianjin 300450,China;Health Management Center,The Fifth Central Hospital of Tianjin,Tianjin 300450,China)

机构地区：[1]天津医科大学肿瘤医院分子影像与核医学诊疗科、国家肿瘤临床医学研究中心、天津市肿瘤防治重点实验室、天津市恶性肿瘤临床医学研究中心,天津300060 [2]天津市第五中心医院超声科,天津300450 [3]天津市第五中心医院健康管理中心,天津300450

出　　处：《肿瘤防治研究》2022年第10期1048-1053,共6页Cancer Research on Prevention and Treatment

摘　　要：目的探讨常规超声分型和超声造影(CEUS)在乳腺非肿块型病变(NMLs)中的应用价值。方法选择天津市第五中心医院经病理证实为乳腺NMLs病变的患者50例(50个病灶),分析NMLs常规超声分型与BI-RADS分类对应关系,并对乳腺NMLs进行超声造影,比较联合BI-RADS及CEUS对其的诊断价值。结果NMLs常规超声分型Ⅰa和Ⅱa病变对应BI-RADS分级为4a级,Ⅲ和Ⅳ型病变对应BI-RADS分级为4b级,Ⅰb和Ⅱb型病变对应BI-RADS分级为4c级。良恶性病变在增强后病变范围有无扩大和是否存在“蟹足征”方面差异有统计学意义(P<0.05)。Pearson相关分析显示增强后病变范围扩大、出现“蟹足征”、峰值强度和曲线下面积与恶性乳腺NMLs相关。CEUS联合BI-RADS分级的诊断价值高于常规超声BI-RADS分级。结论NMLs常规超声分型Ⅰa和Ⅱa病变恶性风险最低,Ⅰb和Ⅱb型病变恶性风险最高。增强后病变范围扩大与出现“蟹足征”现象有助于快速鉴别NMLs良恶性病变。Objective To investigate the application value of conventional ultrasound typing and contrast-enhanced ultrasound(CEUS)in non-mass breast like lesions(NMLs).Methods A total of 50 patients(50 lesions)who were pathologically confirmed to have breast NMLs in Tianjin Fifth Central Hospital.The corresponding relationship between conventional ultrasound typing of NMLs and BI-RADS classification was analyzed,and CEUS was performed on breast NMLs to compare the diagnostic value of combined BIRADS and CEUS.Results The NMLs conventional ultrasound classifiedⅠa andⅡa lesions corresponded to BI-RADS classification 4a;ⅢandⅣlesions corresponded to BI-RADS classification 4b;Ⅰb andⅡb lesions corresponded to BI-RADS classification 4c.A statistically significant correlation was observed between the expansion of lesion range and the presence of“crab foot sign”in benign and malignant lesions after the enhancement(P<0.05).Pearson correlation analysis showed that enlarged lesion area,“crab foot sign,”peak intensity,and area under the curve were associated with malignant breast NMLs.The diagnostic value of CEUS combined with BI-RADS was higher than that of conventional ultrasound BI-RADS.Conclusion NMLs conventional ultrasonographic classificationsⅠa andⅡa have the lowest malignant risk,whereas classificationsⅠb andⅡb have the highest value.The expansion of lesion range and the presence of“crab foot sign”after enhancement are helpful for rapid differentiation of benign and malignant NMLs.

关 键 词：超声造影 乳腺 乳腺非肿块型病变 BI-RADS 

分 类 号：R445.1[医药卫生—影像医学与核医学]