乳腺肿瘤高频彩超及超声造影与微血管密度的相关性

目的 分析乳腺良恶性肿瘤高频彩超、超声造影(CEUS)与微血管密度(MVD)的相关性,探讨超声造影对乳腺肿瘤的诊断价值.资料与方法 82例原发性乳腺肿瘤患者于术前行常规高频彩超检查,观察病灶灰阶图像特征及血流特征；启动造影模式行实时灰阶谐波超声造影检查,应用时间-信号强度曲线分析软件分析病灶增强达峰时间(TTP)、峰值强度(PI)、曲线下面积(AUC)；采用免疫组化测定肿瘤内MVD,分析超声造影定量参数与MVD的相关性.结果 恶性组肿瘤血流Adler分级低于良性组(P＜0.05)；超声造影显像特点:恶性组血管数量多且粗细不等,良性组血流束细窄、平直；恶性组TTP低于良性组,PI及AUC高于良性组(P＜0.05),MVD显著高于良性组(P＜0.001)；肿瘤MVD计数随血流Adler分级升高而升高,CDF1血流丰富程度与MVD呈正相关(r=0.456,P＜ 0.01)； PI与MVD呈显著正相关(r=0.783,P＜0.01).结论 超声造影能客观评价乳腺肿瘤血供,术前应用CDFI结合超声造影在体检查肿瘤血管,可为早期诊断乳腺肿瘤提供信息.

Correlation of High Frequency Color Doppler Ultrasound,Contrast-enhanced Ultrasound and Microvessel Density for Breast Tumor

Purpose To investigate the correlation of high-frequency ultrasound and contrast-enhanced ultrasonography (CEUS) with the microvessel density (MVD) in breast tumors,and evaluate the value of CEUS in the diagnosis of breast tumors.Materials and Methods Eighty-two female patients with primary breast neoplasm underwent conventional high-frequency sonography before operation for examining the features of the gray scale image for the lesions and blood flow.Real time grayscale contrast tuned imaging (CnTI) was performed and a software for time-intensity curve analysis was used to analyze the CEUS patterns and quantitative parameters,including the time to peak (TTP),peak intensity (PI),area under the curve (AUC).Immunohistochemical method was used to detect the MVD at the lesions for examining the correlation between CEUS quantitative parameters and MVD.Results By Adler grade for blood flow,lower grade was seen in malignant breast tumors as compared with the benign cases (P<0.05),and the ultrasonographic patterns were different.The malignant neoplasm displayed heterogeneous enhancement and excessive vascular distribution with varied sizes,whereas the benign cases exhibited a thin and smooth blood stream.TTP for the malignant cases was lower,but PI and AUC were higher compared with the benign cases (P < 0.05).MVD was also significantly increased in the malignant cases over the benign ones (P < 0.001).In addition,MVD at the lesions was elevated with higher Adler grading.The perfusion in color Doppler flow imaging (CDFI) was positively correlated with MVD (r=0.456,P < 0.01),and PI was in significant positive correlation with MVD (r=0.783,P < 0.01).Conclusion CEUS can objectively estimate the blood supply of breast neoplasm,and combined application of preoperative CDFI with CEUS to in vivo detection of the vascular conditions at lesions may provide important information for early diagnosis of breast tumors.