超声造影增强与血流分级联合诊断乳腺肿块性质的研究

目的 将乳腺肿块超声造影增强强度与造影前血流信号强度进行对照比较,并生成定量指标峰值强度,探讨其对病灶良恶性鉴别的价值.方法 对50例乳腺肿块进行超声造影(25例良性,25例恶性),造影前行彩色多普勒血流分级,造影时观察肿块的增强情况,并以肿块所在腺体的增强强度为参照,分为4级:无增强、低增强、等增强、高增强,将其与造影前彩色多普勒分级进行对照分析.应用随机软件计算所有肿块及高增强肿块的峰值强度,并按肿块大小分组比较.结果 超声造影后50例乳腺肿块中41例较造影前血流分级增强,恶性明显多于良性(P＜0.05).回声无增强(2例)与等增强(5例)全部见于良性,低增强9例仅1例见于恶性.高增强(34例)可见于良恶性.超声造影表现为高增强的肿块,最大径＜2 cm时良恶性峰值强度差异有统计学意义(P＜0.05),最大径≥2 cm时峰值强度良恶性间差异无统计学意义(P＞0.05).结论 乳腺超声造影可以明显提高肿块内血管显示率,恶性表现较良性明显,良恶性肿块峰值强度不同,二者相互结合有助于良恶性鉴别诊断,对直径≥2cm,且造影前血流分级为Ⅲ级的肿块峰值强度鉴别诊断的价值不大.

Combination of the contrast-enhanced ultrasound and color Doppler's grade to diagnose breast masses

Objective Comparing the enhancement of contrast-enhanced ultrasound(CEUS) with the intensity of the blood signals of breast masses, and producing the parameter of peak intensity (PI), to determine whether they can reflect the differentiation of the benign breast masses from the malignant ones.Methods Fifty patients with the breast masses (25 benign,25 malignant) were implemented the contrastenhanced ultrasound inspection.The blood signals of the masses could be got before performing the CEUS,then the CEUS was performed.The enhancement of the masses was divided into 4 grades according to the enhancement of breast which was around the mass (no enhancement, low enhancement, equal enhancement,and high enhancement as well).The PIs of all masses and high enhanced massed were calculated by software in machine,then them were compared according to "the groups which had been classified by their maximal diameters.Results Forty-one of 50 cases showed an obvious enhancement using CEUS compared with the routine CDFI.Malignant masses were more obviously than that of benign ones ( P＜0.05).In the 50 cases,the no enhanceed ones( n = 2) and equal enhanced ones( n = 5) were benign,and 1 case of the low enhanced masses( n = 9) was malignant.The high enhanced masses ( n = 34) were malignant or benigh.About the high enhanced masses, there were statistics meanings using the parameter of PI for the masses whose maximal diameters＜2 cm( P＜0.05),and no statistics meanings when their maximal diameters≥2 cm(P＞0.05).Conclusions The CEUS of breast can improve the appreance of the tumor' s blood vessel obviously, especially for malignant masses.The PI of the breast benign masses are different from the malignant ones.Combination of them can help to discriminate benign masses from malignant ones.The parameter of PI is useless for differentially diagnosing the breast masses if their maximal diameters≥2 cm and the blood flow grade Ⅲ before CEUS.