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目的对比分析超声造影与二维超声评估乳腺癌新辅助化疗疗效的价值。方法 9例乳腺癌患者于新辅助化疗前及化疗1个周期后48h分别行二维超声和超声造影检查,观察新辅助化疗前、后病灶大小,病灶血流灌注及内部坏死情况,并比较2种方法评价新辅助化疗的效能。结果新辅助化疗1个周期后48h,二维超声测量病灶最大横径[(11.44±3.94)cm]、上下径[(22.11±7.44)cm]较化疗前[(15.89±2.26)、(28.78±6.92)cm]缩小,差异有统计学意义(P<0.05);超声造影测量病灶最大横径[(18.56±5.22)cm]、上下径[(24.56±6.95)cm]较化疗前[(23.89±4.34)、(30.33±7.35)cm]缩小(P<0.05);二维超声、超声造影在测量化疗前、后病灶最大横径及上下径差异无统计学意义(P>0.05);新辅助化疗1个周期后48h,二维超声测量病灶血流分级0~Ⅰ级7例,Ⅱ级1例,Ⅲ级1例,超声造影显示增强强度0~1级1例,2级6例,3级2例,超声造影在显示病灶血流灌注强度上优于二维超声(P<0.05);新辅助化疗1个周期后48h,二维超声测量病灶内部伴极低或无回声1例,而超声造影显示病灶伴充盈缺损6例,超声造影在显示病灶坏死上优于二维超声(P<0.05)。结论与二维超声比较,超声造影在评价乳腺癌新辅助化疗疗效中有明显优势。
Objective To compare the value of contrast-enhanced ultrasound and two-dimensional ultrasonography in assessing the efficacy of neoadjuvant chemotherapy in breast cancer. Methods Nine patients with breast cancer before neoadjuvant chemotherapy and one cycle after chemotherapy 48h were examined by two-dimensional ultrasound and contrast-enhanced ultrasound before and after neoadjuvant chemotherapy to observe the lesion size, lesion perfusion and internal necrosis, and compared 2 Methods to evaluate the efficacy of neoadjuvant chemotherapy. Results After 48 hours of neoadjuvant chemotherapy, the maximum diameter of the lesion measured by two-dimensional ultrasonography was (11.44 ± 3.94) cm and the diameter [(22.11 ± 7.44) cm] compared with that before chemotherapy [(15.89 ± 2.26) and (28.78 ± 6.92) cm], the difference was statistically significant (P <0.05); the maximum diameter of lesion was (18.56 ± 5.22) cm and the diameter [(24.56 ± 6.95) cm] 4.34) and (30.33 ± 7.35) cm, respectively (P <0.05). There was no significant difference in the maximum diameter and the diameter of the upper and lower lesions before and after the two-dimensional ultrasound and contrast-enhanced ultrasound 48h after 1 cycle, the blood flow grade of 0 ~ Ⅰ grade in 7 cases, Ⅱ grade in 1 case, Ⅲ grade in 1 case were measured by two-dimensional ultrasonography, the intensity of enhanced ultrasound was 1 grade in grade 0 ~ 1, 6 grade in grade 2, 2 cases, contrast-enhanced ultrasound showed better perfusion intensity than two-dimensional ultrasonography (P <0.05); 48 hours after neoadjuvant chemotherapy, there was 1 case with low or no echo in two-dimensional ultrasonography, Angiography showed lesions with filling defects in 6 cases, contrast-enhanced ultrasound showed better than two-dimensional ultrasound in lesion necrosis (P <0.05). Conclusion Compared with two-dimensional ultrasound, contrast-enhanced ultrasound in the evaluation of the efficacy of neoadjuvant chemotherapy in breast cancer has obvious advantages.