Breast cancer angiogenesis: A quantitative morphologic and doppler imaging study

Background: Tumor growth and metastases require the development of new vessels (angiogenesis). Angiogenesis, assessed by microvessel count using immunocytochemical stain of endothelial cells, has been shown to predict metastases and correlate with early death. Recently developed color Doppler mapping can detect the “tumor flow signals” in breast cancer and help to distinguish it from benign lesions. The question is, does this tumor vascularization assessed by color Doppler mapping correlate with the angiogenesis assessed by immunocytochemistry? Methods: Eighty-four patients admitted for breast surgery were studied. The final diagnosis was made by pathology for 52 malignancies and 32 benign lesions. The color Doppler mapping of the breast lesion was made preoperatively. The following parameters were assessed: (a) vessel location (peripheral or central); (b) density of color Doppler signals; and (c) maximum systolic velocity. Tumor angiogenesis was assessed by microvessel count under light microscopy using the platelet/endothelial cell adhesion molecule antibodies (CD31) method. The correlation between maximum velocity and microvessel count of breast cancer was examined. The clinical significance of maximum flow velocity of breast cancer with various clinicopathologic factors was assessed. Results: Color signals were detected in 48 cases of 52 malignancies (92%). All tumors demonstrated signals at the periphery of the lesion but in only 13 (27%) were the signals detected within the tumor. Color signals were scored as + + or + + + in 44 (92%) patients. Pulsed wave blood flow was shown in all these 48 tumors, with maximum velocities varying from 4 to 36 cm/s. Among the 32 benign lesions, color signals were detected in 10 (31%) and all were peripheral and scored subjectively as +. Evaluation of these color Doppler mapping parameters shows no significant correlation with microvessel counts using CD31 monoclonal antibodies. However, there was a positive association (p<0.05) between nodal metastases and higher tumor flow velocity in T1 (<2 cm) breast tumors but not in larger tumors. Conclusion: Although the color Doppler mapping has been shown to be useful in distinguishing benign from malignant breast lesions, the intensity of signal and velocity of flow had no correlation with the extent of angiogenesis of breast cancer. The presence of high-flow tumor signal in early breast carcinoma is significantly associated with the presence of axillary lymph node metastases.     

2型糖尿病患者四肢血管的彩色多普勒研究

为了解２型糖尿病（ＤＭ）患者四肢动脉血管及血流的改变情况,我们应用Ａｃｕｓｏｎ １２８ ＸＰ／１０ 彩色多普勒超声仪,对５０ 例ＤＭ 患者进行测定并与正常对照组作比较。结果显示：①２ 型ＤＭ 患者动脉血管壁较正常人回声明显增加,内膜增厚,管壁不光滑、僵硬,部分患者四肢血管内可探及粥样斑块回声（１４／５０）,以胫前动脉斑块病变为多（９／５０）。其中１ 例为临床无四肢症状者;②２ 型ＤＭ 患者四肢动脉血管内径明显低于正常对照组（Ｐ＜０．０５）,且有四肢症状存在者较无症状者（除左侧胫前动脉外）血管内径有进一步变细;③正常人四肢动脉频谱形态主要呈三峰,少数出现单峰,而２型ＤＭ 患者频谱形态主要呈单峰且频谱增宽,出现舒张期持续灌注,与正常组比较有显著性差异（Ｐ值分别＜ ０．０１ 和＜ ０．０５）;④２ 型ＤＭ 患者四肢血流峰值流速（ＰＶ）较正常对照有加快,但差异无显著性,有四肢症状存在者较无症状者峰值流速有进一步加快的趋势。本试验结果提示：２ 型糖尿病患者的上、下肢动脉血管均受累,采用彩色多普勒检查患者四肢动脉血流动力学及血管定位改变,对ＤＭ 患者周围血管病变的诊断,尤对无症状患者早期诊断具有一定价值。     

应用彩色多普勒血流显像检测眼前部缺血性视神经病变

应用彩色多普勒血流显像检测眼前部缺血性视神经病变,以探讨其血流动力学变化特征。     

阴道彩超检测卵巢动脉主干血流对卵巢肿瘤定性诊断的研究

目的：研究用阴道彩色超声多普勒血流显象（ＴＶＳ－ＣＤＦＩ）技术检测卵巢动脉主干血流定性诊断卵巢肿瘤。方法：应用ＴＶＳ—ＣＤＦＩ技术检测正常妇女５６例、卵巢良性肿物６２例及卵巢恶性肿瘤３２例卵巢动脉总干血流的Ａ（收缩期末血流速度峰值）、Ｂ（舒张期末血流速度峰值）、ＰＩ（搏动指数）、ＲＩ（阻力指数）值，并观察其图型特点。结果：卵巢恶性肿瘤的Ｂ、ＰＩ、ＲＩ与正常卵巢及良性肿瘤测值差异有显著性（Ｐ＜０．０５）；恶性卵巢肿瘤内血管为低阻力血管，卵巢动脉主干也随之发生变化，致ＰＩ、ＲＩ降低；将ＰＩ＝１．２０，ＲＩ＝０．６２作为诊断卵巢恶性肿瘤的界值，其灵敏度、特异度、阳性预测值、阴性预测值指标与声像图诊断相比，均明显提高。结论：ＴＶＳ－ＣＤＦＩ检测卵巢动脉总干血流对鉴别卵巢肿瘤的良、恶性具有重要的意义。     

乳腺肿瘤的高频超声检查与鉴别诊断

目的对乳腺肿瘤的高频声像图特征与CDFI的表现进行探讨.方法对59例经手术、病理证实为乳腺肿瘤的高频声像图与病理进行对照.结果高频超声在肿块的物理性质诊断方面符合率达100%,在肿块良恶性鉴别诊断方面符合率为87.4%.本组的病灶好发于乳腺外上象限及内上象限,良性肿瘤彩色血流显示率低,且多位于肿瘤周边部,血流检出率为48.6%(17/35);而恶性肿瘤内部见短条状血流信号,血流检出率为91.7%(22/24),两者差异有显著性(P<0.004).结论乳腺肿瘤有明显声像特征,高频超声诊断符合率高.     

彩色多普勒超声对颈部淋巴结诊断价值的分析

目的探讨彩色多普勒超声(CDFI)对颈部淋巴结的诊断价值,提高彩超对不同疾病所致淋巴结肿大的鉴别诊断水平。方法应用彩超观察共62例124个颈部肿大淋巴结(分良、恶性两组)的长径与短径之比(L/S),内部回声及CDFI血流特征。结果良性肿大淋巴结形态呈椭圆形,L/S比值>2,内部回声多为髓质增强、增宽,皮质相对变窄,门部回声规则存在。恶性肿大淋巴结形态呈类圆形,L/S比值<2,内部回声以皮质低回声为主,或强弱不等或非均匀性增厚,髓质及门部强回声变形偏移、不规则或消失。CDFI示良性肿大淋巴结内多呈门部规则血流,呈低速低阻型,部分未见血流。恶性肿大淋巴结内多呈不规则血流及周边包绕血流,血流速度Vmax及阻力指数RI显著高于良性组(P<0.01)。结论根据彩色多普勒血流及二维声像图特点、结合病史等,超声检查对颈部肿大淋巴结良、恶性鉴别有一定诊断价值,可作为首选方法。     

彩色多普勒超声对肝移植术后血流动力学的监测研究

目的 利用彩色多普勒超声检测移植肝血流动力学的参数,探讨参数变化的临床意义.方法 利用彩色多普勒超声检测25例肝移植患者不同时期的肝动脉、肝静脉及门静脉的峰值血流速度(PS)、肝动脉阻力指数(RI).结果 术后2周内,移植肝正常者门静脉PS及肝动脉RI均明显高于对照组(P＜0.05);肝动脉PS明显低于对照组(P＜0.05).结论 CDI 技术对了解肝移植术后移植肝的灌注情况,及早发现肝移植术后早期的并发症有重要意义.     

彩色多普勒超声检测异位妊娠患者卵巢黄体血流动力学变化的临床价值

目的 探讨彩色多普勒（CDFI）超声检测异位妊娠卵巢黄体血流变化的临床价值。方法 1998-02—2005—10广州医学院第二附属医院和广东增城市人民医院运用CDFI分别对20例胚胎存活型异位妊娠。36例流产型异位妊娠和45例宫内妊娠孕妇黄体血流动力学参数（收缩期峰值流速SPV、阻力指数RI）进行统计学处理和对照分析，并观察卵巢内黄体血流分布特点。结果 胚胎存活型异位妊娠组黄体血流峰值、血流阻力指数与宫内妊娠组比较无明显差异。流产型异位妊娠组黄体血流峰值明显低于宫内妊娠组及胚胎存活型异位妊娠组（P〈0．01），而血流阻力指教则高于宫内妊娠组及胚胎存活型异位妊娠组（P〈0．01）。结论 CDFI检测卵巢黄体血流对诊断是否存在异位妊娠无明显意义，但对异位妊娠中胚胎是否存活具有较高的诊断价值。     

1980例孕中晚期胎儿彩色多普勒超声检查结果回顾性分析

目的:利用彩色多普勒超声筛查孕中晚期胎儿异常或畸形,降低围产死亡率,提高人口出生质量。方法:对我院2002年1月至2005年3月1980例孕中晚期胎儿彩色多普勒超声检查结果回顾性分析。结果:检出胎儿畸形45例,死胎12例,低置胎盘24例,38周～42周胎位不正51例、脐绕颈316例。其中绝大多数在本院或外院引产证实,少数经过尸解证实。结论:彩色多普勒超声可发现大多数的胎儿形态结构异常,使一些致死性的畸形及早终止妊娠,非致死性的异常或畸形有了选择的空间;在提高人的出生质量上彩色多普勒超声起着不可或缺的作用,而且越来越显现出其独特的功能所在。