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目的乳腺超声成像是乳腺疾病诊断不可或缺的主要技术,造影技术又克服了传统超声的局限性,极大提高了检测肿块低速血流的敏感性。本研究观察乳腺良恶性肿块的超声图像及超声造影表现,探讨其超声图像及超声造影的特征。方法对2013-01-01-2015-06-30在广西壮族自治区人民医院就诊及手术治疗的451例乳腺肿块患者的超声图像特征、血流情况进行观察及实时超声造影,选用SonoVue超声造影剂,对肿块的高频超声图像、造影增强形态、强度和造影时间-强度曲线特征进行观察,并与病理进行对照分析。结果经病理确诊451例乳腺肿块中,恶性肿块240例,良性肿块211例,超声造影有其特征性表现。(1)恶性肿块表现为进入丰富,分布尚均及不均。其造影强度分别为高增强188例(78.3%),中等增强43例(17.9%),极少至低增强9例(3.8%)。(2)进入肿块的增强范围常超过二维超声图像,周围可见多条粗大的血管进入肿块,恶性肿块范围增大、放射状增强、穿支血管均较良性明显增加,良性肿块可见环状增强,并为特征性改变,共59例(28.0%)。(3)本组恶性肿块超声造影敏感度92.45%,特异度95.91%,阳性预测值96.66%,阴性预测值90.82%。本组恶性肿块二维超声检查敏感度82.63%,特异度65.02%,阳性预测值60.40%,阴性预测值85.29%。结论通过系统地对乳腺恶性肿块超声图像及超声造影表现进行观察,进一步发现了不同乳腺肿块,尤其是恶性肿块的超声造影特征表现,认为超声造影可提高对乳腺肿块低速血流显示的敏感度,并有其特征性表现,有助于乳腺良恶性病变的鉴别诊断及提高诊断准确率。
Objective Mammography is an indispensable technique in the diagnosis of breast disease. The contrast technique overcomes the limitations of conventional ultrasound and greatly improves the sensitivity of detecting low velocity blood flow. This study was to observe the benign and malignant breast ultrasound imaging and ultrasound imaging performance, to explore the characteristics of ultrasound images and contrast-enhanced ultrasound. Methods 451 cases of breast lumps treated and operated in People’s Hospital of Guangxi Zhuang Autonomous Region between January 1, 2015 and January 15, 2015 were enrolled in this study. Ultrasound images, blood flow and real-time contrast echocardiography were observed. SonoVue ultrasound contrast agent was selected. High-frequency ultrasound images of lumps, contrast-enhanced morphology, intensity and contrast-time-intensity curve characteristics were observed and compared with the pathology. Results Of the 451 breast masses diagnosed by pathology, there were 240 malignant masses and 211 benign masses with contrast-enhanced ultrasonography. (1) Malignant tumor manifested as rich, evenly distributed and uneven distribution. There were 188 cases (78.3%) with contrast enhancement, 43 cases (17.9%) with moderate enhancement, and 9 cases (3.8%) with minimal to low enhancement. (2) The enhancement range of tumor mass often exceeds that of two-dimensional ultrasound image. A large number of thick blood vessels can be seen around the tumor. The range of malignant tumors increases and increases radially. The perforation blood vessels are significantly increased compared with benign tumors, And for the characteristic changes, a total of 59 cases (28.0%). (3) The sensitivity, specificity and 95.91% of the malignant mass in this group were 92.45%, 96.66% and 90.82%, respectively. The sensitivity and specificity of two-dimensional ultrasonography in this group were 82.63%, 65.02%, 60.40% and 85.29%, respectively. Conclusions The ultrasonographic and ultrasonographic manifestations of malignant breast masses are observed systematically to further characterize the features of different breast masses, especially malignant masses. It is suggested that contrast enhanced ultrasound can enhance the sensitivity of low intensity blood flow to breast masses, And has its characteristic performance, contribute to the differential diagnosis of benign and malignant breast lesions and improve diagnostic accuracy.