乳腺导管内癌的超声图像及造影特征与病理对照分析  

Characteristic of Ultrasonography and Contrast-enhanced Ultrasound for the Breast Ductal Carcinoma in Situ Correlation with Pathology

作　　者：贺琰[1] 王小燕[1] 凌冰[1] 韦海明[2] 农美芬[1] 陈雪雪[1] 裴华洁[1] 

机构地区：[1]广西壮族自治区人民医院超声科,南宁市530021 [2]广西壮族自治区人民医院病理科,南宁市530021

出　　处：《中国超声医学杂志》2015年第6期494-497,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广西科学研究与技术开发计划项目(No.桂科攻0592007-2c);(No.桂科攻14124004-1-13)

摘　　要：目的观察乳腺导管内癌的超声图像及超声造影特征,探讨该技术对乳腺导管内癌的诊断价值。方法对62例乳腺导管内癌患者的超声图像特征、血流动力学进行观察及实时超声造影,选用SonoVue超声造影剂,对肿块的高频超声图像及造影增强形态、强度及造影时间-强度曲线特征进行了观察,并与病理进行了对照分析。结果经病理证实62例乳腺导管内癌高频超声图像具有一定的特征表现,表现为除肿块边界不清晰、形态不规则外,内部回声大体可分为3型,I型:声像图表现肿块内呈稍低回声及近等回声,内回声不均,轻度强弱不等;Ⅱ型:肿块表现为稍低及低回声肿块,内部回声明显强弱不等,内见散在小低回声区,类似局限性乳腺增生的团状"豹纹征"改变;Ⅲ型:混合性肿块型,可表现为囊实性肿块,或肿块内及周边见多条管状无回声区,部分管状无回声区内见实性团状回声。超声造影表现为进入丰富,分布尚均及不均;造影剂进入肿块的大小及范围经常超过二维超声图像,周围见多条粗大的血管进入肿块。结论乳腺导管内癌在超声造影下可呈现特征表现,超声高频图像与超声造影两者结合有助于提高诊断符合率。Objective To observe the ultrasonography pattern and contrast-enhanced ultrasound(CEU)characteristic of the breast ductal carcinoma in situ(DCIS),and to investigate its diagnostic value for DCIS.Methods 62 cases of ultrasonography pattern and hemodynamics regularity for DCIS,using color doppler real-time contrast which were observed using SonoVue.The high frequency ultrasound pattern,enhancement form,intensity and the time-intensity curve of lump were observed.The results were correlated with pathology.Results The high frequency ultrasound was pattern of DCIS divided into 3types,Ⅰ:low or equal echo mixed lump with heterogeneous;Ⅱ:The lump,which shows a low or a lower echo mixed lump with heterogeneous,small and dark areas,like Hyperplasia of mammary glands with leopard;Ⅲ:mixed solid and cystic mass with inner and surrounding liquid tubular area,the liquid area with main groups within the solid mass echo.The CEU appeared heterogeneous and high or equal enhancement,The time-intensity curve displayed 'fast washin and slow washout'.Conclusions The manifestation of ultrasound pattern and hemodynamics for DCIS were characteristic correlated with pathology.The combination of them could improve the rate of diagnosis accuracy.

关 键 词：乳腺导管内癌 超声图像 超声造影 病理学 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]