摘要
目的探讨乳腺癌超声造影有无充盈缺损与超声造影及临床病理等指标的相关性。方法对可疑乳腺病灶行超声造影，回顾性分析119例有病理结果的乳腺癌的造影情况，观察增强效果、造影剂分布、造影剂进入肿瘤顺序、造影模式、穿支血管、有无充盈缺损及血流分级，并收集临床病理资料，包括肿块大小、临床分期、组织性分级及有无病理微钙化。以有无灌注缺损作为分组因素，其中无灌注缺损82例，有灌注缺损37例，用单因素和多因素分析灌注缺损情况与超声造影、临床病理参数的关系。结果单因素和多因素分析显示超声造影分布、造影剂进入肿瘤的顺序及组织学分级与超声造影有无充盈缺损关系密切（X^2=19．5050、21．1210、10．3640，OR=6．977、0．261、2．509，P均〈O．05）。多因素分析提示肿瘤大小与超声造影有无充盈缺损关系密切（OR=1．692，Pd0．05）。临床分期、是否有穿人性血流信号在单因素分析中有意义，在多因素分析中被剔除。单因素和多因素分析均显示造影模式、增强效果、血流分级、病理微钙化的显示与超声造影有无充盈缺损无关联。结论超声造影出现充盈缺损与超声造影良恶性诊断的相关因素并不完全一致。超声造影显示充盈缺损的乳腺癌更倾向于肿块较大，造影剂分布呈周边增强，造影剂进入肿瘤的顺序多呈向心性充填及更高的组织学分级。
Objective To study the ultrasonic imaging of breast cancer with or without filling defect with contrast-enhanced ultrasound and clinical pathologic correlation. Methods The suspicious breast lesions underwent contrast-enhanced ultrasound examination, the imaging of 119 breast cancer with pathological results were retrospectively analyzed, and the contrast enhanced ultrasound effect, distribution of contrast agent,sequence of contrast agent into the tumor, contrast enhanced ultrasound mode,perforator vessel, filling defect and flow classification were observed. Then clinical and pathological data were collected including the tumor size, clinical stage, pathological grade and the situation of micro calcification. The perfusion defect as the grouping factor, there were 37 cases of perfusion defect and 82 cases without perfusion defect. A mono-pactor and multi factor analysis was performed by the logistic regression models to the relationship between perfusion defect and contrast-enhanced ultrasonography, clinical pathological parameters. Results Both mono factor and multifactor analysis displayed that whether to display the filling defect in contrast enhanced ultrasound was associated with ultrasound contrast distribution,the sequence of contrast agent into the tumor and histological grade （X^2 = 19.5050,21.1210,10.3640, OR = 6.977,0.261, 2.509, all P〈0.05）. Multivariate analysis showed that tumor size and whether to display the filling defect in contrast enhanced ultrasound were close （ OR = 1.692, P〈0.05） .Clinical stage, whether the blood flow signal penetrates was meaningful in univariate analysis but excluded in multivariate analysis. Both mono factor and multifactor analysis displayed that contrast enhanced ultrasound mode, contrast enhanced ultrasound effect, flow classification and pathological micro calcification were not associated with whether todisplay the filling defect. Conclusions Whether to display the filling defect and the related factors of contrast-enhanced ultrasound in diagnosis of benign and malignant were not completely consistent. Breast cancers with filling defects of contrast-enhanced ultrasound tend to present large masses, contrast agent distribution of peripheral enhancement, centripetal filling of ultrasound contrast agents and the higer histological grading.
出处
《中华超声影像学杂志》
CSCD
北大核心
2015年第5期417-421,共5页
Chinese Journal of Ultrasonography
基金
国家自然科学基金项目（81260332）
关键词
超声检查
微气泡
乳腺肿瘤
充盈缺损
Ultrasonography
Microbubbles
Breast neoplasms
Filling defect
