超声造影对乳腺良恶性肿瘤的鉴别诊断价值  

Application value of contrast-enhanced ultrasound in differential diagnosis of malignant and benign breast lesions

作　　者：韩鄂辉[1] 吕志红[1] 洪玮[1] 沈荣[1] 黄娅娟[1] 王君芳[1] 

机构地区：[1]黄石市中心医院超声影像科,湖北黄石435000

出　　处：《肿瘤影像学》2015年第2期115-118,共4页Oncoradiology

摘　　要：目的:进一步研究超声造影在乳腺病灶鉴别诊断中的应用价值。方法:以病理结果为标准,对术前261例患者二维超声发现的307个乳腺肿块进行超声造影动态过程分析,并用Sono Liver软件获得时间-强度曲线的各参数值,最后与术后病理结果进行对照。结果:恶性肿瘤的超声造影表现为病灶早期快速非均匀高增强,周边放射状增强;而良性肿瘤则表现为病灶早期缓慢均匀弱增强和无增强,均无周边放射状增强,两者比较差异有统计学意义(P<0.05)。乳腺病灶造影后纵径/横径比显著减小考虑恶性肿瘤。恶性病灶感兴趣区的峰值强度比值与良性病灶相比有差异。造影结果与病理结果对照,186个良性病灶166个诊断正确,20个误诊为恶性病灶;121个恶性病灶103个诊断正确,18个误诊为良性。诊断恶性肿瘤的灵敏度为85.1%,特异度为89.2%,准确率为87.6%。结论:超声造影可动态观察乳腺病灶内微血管血流灌注状况,用Sono Liver软件可进一步对病灶进行量化分析,有助于提高乳腺良恶性病灶的鉴别诊断。Objective: To explore the application value of contrast-enhanced ultrasound in differential diagnosis of malignant and benign breast lesions. Methods: A total of 306 breast lesions from 261 patients found by 2-dimensional ultrasound were conducted contrast-enhanced ultrasound. Sono Liver software was used to acquire the parameters of timeintensity curve. The analysis results were compared with the pathological results. Results: On contrast-enhanced ultrasound, the malignant lesions showed quick and uneven enhancement with peripheral radial enhancement during early phase. But the benign lesions showed even, slow and weak enhancement or no enhancement, and they had no peripheral radial enhancement. There was significant difference between the malignant and benign lesions(P<0.05). The decrease in breadth-length ratio of breast lesions suggested malignant lesion. There was difference in peak intensity ratio of region of interest(ROI) between benign and malignant lesions. Compared with the results of pathology, 166 were correctly diagnosed and 20 were misdiagnosed in 181 benign lesions; and 103 were correctly diagnosed and 18 were misdiagnosed in 121 malignant lesions. The sensitivity of diagnosis of malignant lesions was 85.1%, the specificity was 85.1%, and the accuracy was 87.6%. Conclusion: Contrast-enhanced ultrasound could dynamically observe the microvascular perfusion status in breast lesions. Sono Liver software could make further quantitative analysis and improve the differential diagnosis of benign and malignant breast lesions.

关 键 词：乳腺肿瘤 超声造影 时间-强度曲线 

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]