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目的:探讨糖尿病性乳腺病(diabetic mastopathy,DMP)的常规超声、超声造影(CEUS)及弹性成像(UE)图的超声表现,旨在提高超声工作者对该病的认识。方法:回顾分析经病理证实的19例DMP的常规超声、超声造影及弹性成像图特征。结果:19例患者21个病灶术前常规超声诊断均为恶性,根据乳腺超声影像学报告及数据系统(breast imaging reporting and data systemultrasound,BI-RADS-US)描述的主要恶性征象包括:形态不规则,后方回声衰减,边界不清晰,内部回声不均匀,肿块前方见高回声晕。其中16例为BI-RADS 4级(4a 2例,4b 10例,4c 4例),5例为BI-RADS 5级。彩色多普勒超声显示11个病灶周边可见彩色血流信号,4例病灶内部可见Ⅱ级以下血流信号,17例病灶内部未探及彩色血流信号。有超声造影资料的15例病灶中,以病灶内部见少许造影剂进入(12/15)、强度低于周边正常乳腺组织(13/15)、呈“慢进慢退”(10/15)、未见粗大扭曲血管(13/15)的征象多见。有超声弹性成像资料的17例病灶弹性评分为4分10例,5分7例。结论:术前超声检查难以明确鉴别诊断DMP与乳腺癌,CEUS对DMP具有一定价值,对于疑似乳腺癌的肿块出现病灶内部CEUS见少许造影剂进入,强度低于周边正常乳腺组织、未见粗大扭曲血管时,应与DMP进行鉴别诊断,但是确诊需依靠病理学检查结果。
Objective: To investigate the ultrasound manifestations of conventional ultrasound, contrast-enhanced ultrasound (CEUS) and elastography (UE) images of diabetic mastopathy (DMP) in order to improve the understanding of the disease among the ultrasound workers. Methods: The features of conventional ultrasound, contrast-enhanced ultrasound and elastography of 19 DMP confirmed by pathology were retrospectively analyzed. RESULTS: Twenty-one of the 19 patients had preoperative routine sonographic diagnosis of malignancy. The major malignant features described by the breast imaging reporting and data systemultrasound (BI-RADS-US) included morphological irregularities , The back of the echo attenuation, the boundary is not clear, the internal echo uneven, see the front of the mass hyperechogenic halo. Among them, 16 were BI-RADS grade 4 (4a 2 cases, 4b 10 cases, 4c 4 cases) and 5 cases were BI-RADS grade 5. Color Doppler ultrasound showed that the color flow signals were visible around the 11 lesions, blood flow signals below grade Ⅱ were seen in 4 lesions, and intrahepatic color flow signals were not detected in 17 lesions. Among the 15 lesions with contrast-enhanced ultrasound data, a small amount of contrast agent was seen inside the lesion (12/15), which was lower than that of normal breast tissue (13/15) ), No signs of grossly distorted blood vessels (13/15) are more common. Seventeen patients with echographic elastography had a score of 4 points and 10 cases in 5 cases and 7 cases in 5 points. Conclusions: Preoperative ultrasonography is difficult to differentiate DMP from breast cancer. CEUS is of value to DMP. For suspected breast cancer, CEUS inside the lesion appears with a little contrast agent, and the intensity is lower than that of the surrounding normal breast tissue with no gross distortions Vascular, and DMP should be differential diagnosis, but the diagnosis depends on the results of pathological examination.