摘要
目的探讨超声造影在乳腺病灶鉴别诊断中的应用价值。方法以病理结果为金标准,对术前261例二维超声发现乳腺肿块的患者进行超声造影动态过程分析,应用Sono Liver软件获得时间-强度曲线(time-intensity curve,TIC)各参数值,并与术后病理结果(良性169例/186个,恶性92例/121个)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。乳腺病灶造影后长宽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差异有统计学意义(P<0.01)。造影结果与病理结果对照,186个良性病灶中166个诊断正确,20个误诊为恶性;121个恶性病灶中103个诊断正确,有18个误诊为良性。对恶性肿瘤敏感性为85.1%,特异性为89.2%,准确性为87.6%。结论超声造影可以动态观察乳腺病灶内微血管血流灌注状况,应用Sono Liver软件可对病灶进一步量化分析,有助于提高乳腺良恶性病灶的鉴别诊断水平。
Objective To explore the value of contrast enhanced ultrasound （CEUS） breast lesions in differ-ential diagnosis .Methods Making the results of the pathology test as standard , an CEUS process analysis of breast 〈br〉 lesions was performed in 261 patients who were diagnosed as breast tumor by 2-dimensional CEUS before operation and the parameter value of Time-Intensity Curve was gotten by SonoLiver software , and the results obtained were com-pared with the result of the pathology test after operation （benign 169 cases/186 lesions, malignant 92 cases/121 le-sions）.Results The CEUS of malignant tumor showed that lesions had an early rapid , non-uniform, high enhance-ment and peripheral radial enhancement .The benign tumor showed that lesions had an early slow , uniform, low or no enhancement , and no peripheral radial enhancement .Significant decrease of length width ratio of breast lesions after radiography maybe suggest a malignant tumor .There was a significant difference in the ROI mode intensity between benign and malignant lesions （ P〈0.01 ） .Comparison of the results between radiography and pathology shaved , in 181 benign lesions , 166 were correct on CEUS , 20 were misdiagnosed as malignant , and in 121 malignant lesions , 103 were correct on CEUS , 18 were misdiagnosed as benign .For diagnosis of malignant tumor , CEUS showed the sensitivity was 85.1%, specificity was 89.2%and accuracy was 87.6%.Conclusion CEUS can observe dynami-cally the situation of microvascular blood perfusion in breast lesions , and application of SonoLiver software can ana-lyze lesions quantitatively and improve the levels of differential diagnosis of benign and malignant breast tumors .
出处
《中国临床新医学》
2015年第4期342-346,共5页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
