超声造影联合钼靶X线诊断乳头状瘤的临床价值  

Clinical value of contrastation-enhanced ultrasound combined with molybdenum target X-ray in the diagnosis of papilloma

作　　者：姜颖双 刘彦春 李鑫[3] JIANG Yingshuang;LIU Yanchun;LI Xin(Department of Ultrasound,the First People's Hospital of Jinzhou District of Dalian,Dalian,Liaoning,116100,China;Department of Ultrasound,Dalian Ganjingzi District Maternal and Child Health Care Hospital,Dalian,Liaoning,116033,China;Department of Radiology,the Second Affiliated Hospital of Dalian Medical University,Diamond Bay Yard,Dalian,Liaoning,116000,China)

机构地区：[1]大连市金州区第一人民医院超声科,辽宁大连116100 [2]大连市甘井子区妇幼保健院超声科,辽宁大连116033 [3]大连医科大学附属二院钻石湾院区放射线科,辽宁大连116000

出　　处：《当代医学》2022年第36期12-15,共4页Contemporary Medicine

摘　　要：目的探讨超声造影联合钼靶X线诊断乳头状瘤的临床价值。方法回顾性分析2019年1月至2020年6月大连市金州区第一人民医院超声科收治的90例乳腺导管病变患者临床资料。患者均行病理检查、超声造影及钼靶X线检查。观察钼靶X线与超声造影下乳头状瘤的影像学特征;比较超声造影、钼靶X线及超声造影联合钼靶X线诊断准确率及诊断导管乳头状瘤的诊断价值。结果Ⅰ型,主要表现为导管扩张且伴不同程度导管内乳头状不同程度实性回声,以中等实性回声为主并多处于中央大导管位置。Ⅱ型,以病灶内不规则囊性暗区样变化为主,可见中等程度回声。Ⅲ型,导管不同程度局限性扩张,管壁光滑或成不规则样改变。Ⅳ型,导管内实性肿瘤,导管无明显扩张。直接征象可见乳头状瘤边缘放射状毛刺状改变,或病灶内可见不同程度泥沙样、针尖样、单簇或多聚集性钙化改变,可散在分布或聚集,钙化大小不同。间接征象可见导管变粗成漏斗状,或见血管异常增厚及厚皮影,呈现牛角征或塔尖征。90例乳腺导管病变患者中,病理诊断导管乳头状瘤75例,超声造影确诊65例,钼靶X线确诊64例,超声造影联合钼靶X线诊断确诊72例;超声造影联合钼靶X线诊断导管乳头状瘤准确率高于钼靶X线、超声造影,差异有统计学意义(P<0.05)。ROC曲线结果显示,超声造影、钼靶X线及超声造影联合钼靶X线诊断乳腺导管乳头状瘤的AUC分别为0.873、0.813、0.924;超声造影联合钼靶X线的特异度与灵敏度优于超声造影、钼靶X线,差异有统计学意义(P<0.05)。结论超声造影联合钼靶X线在乳腺导管乳头状瘤诊断中具有较高的应用价值,极大提升准确率、特异度及灵敏度,对于判断病情进展、评估患者预后具有重要意义。Objective To investigate the clinical value of contra-enhanced ultrasound combined with molybdenum target X-ray in the diagnosis of papilloma.Methods The clinical data of 90 patients with breast duct lesions admitted to the First People's Hospital of Jinzhou District of Dalian from January 2019 to June 2020 were retrospectively analyzed.All patients underwent pathological examination,contrast-enhanced ultrasound and molybdenum target X-ray.The imaging features of papilloma under molybdenum target X-ray and contrast-enhanced ultrasound were observed;the diagnostic accuracy of contrast-enhanced ultrasound and molybdenum target X-ray and contrast-enhanced ultrasound combined with molybdenum target X-ray were compared;to compare the diagnostic accuracy and diagnostic value of contrast-enhanced ultrasound,mammography and contrastenhanced ultrasound combined with mammography in the diagnosis of ductal papilloma.Results TypeⅠ,mainly manifested as catheter dilation with different degrees of intraductal papillary solid echo,mainly medium solid echo and mostly in the central large catheter position.TypeⅡ,characterized by irregular cystic dark-area changes in the lesion,with moderate echo.TypeⅢ,varying degrees of localized catheter dilation,wall smooth or irregular changes.Type IV,solid intraductal tumor,no obvious catheter dilation.The immediate signs are radial burr changes at the edge of papilloma,or different degrees of sediment,needle,single cluster or multiple aggregation of calcification changes within the lesion,which may be scattered or aggregated,with different calcification sizes.Indirect signs can be seen in the catheter thickened into a funnel shape,or abnormal vascular thickening and thick shadow shadow,showing bull horn sign or spire sign.Among the 90 patients with breast duct lesions,75 cases were pathologically diagnosed with ductal papilloma,65 cases were diagnosed with contrast-enhanced ultrasound,64 cases were diagnosed with molybdenum target X-ray,and 72 cases were diagnosed with contrast-enhanced

关 键 词：超声造影 钼靶X线 乳头状瘤 特异度 

分 类 号：R730.41[医药卫生—肿瘤]