CAJ | 학술논문

目的分析乳腺局灶性腺病的超声造影表现,探讨超声造影在乳腺腺病诊断及鉴别诊断中的应用价值.方法回顾性分析110例经手术病理证实的乳腺腺病患者的常规超声及超声造影资料,观察记录肿块的超声造影特征,分析肿块的造影增强模式、边界特征及时间-强度曲线.结果 110例中常规超声检出151个病灶,诊断为腺病或腺病瘤61例,诊断符合率40.4％(61/151).超声造影诊断为腺病或腺病瘤106例,诊断符合率70.2％(106/151),高于常规超声.实时超声造影增强特点为:在造影剂灌注达峰时,103个病灶(68.2％)以整体或部分不均匀增强为主.121个病灶(80.1％)增强程度以中等增强或稍高增强为主,少数病灶(11.9％,18/151)显示为明显高增强,极少数病灶(7.9％,12/151)为低增强.107个病灶(70.9％)在造影剂灌注达峰时边界欠清晰,无包膜,与周围背景乳腺组织具有一定的延续性,其中5个病灶在增强后其体积较常规超声显示明显增大,4个病灶在造影剂灌注达峰时边界似呈毛刺状,无规律性;29.1％(44/151)的病灶边界较清晰.在高增强和等增强的病灶中,时间强度曲线形态以“同进同出型”(60/151,39.7％)和“快进快出型”(65/151,43.0％)为主.结论乳腺局灶性腺病的超声造影图像有一定特征,通过超声造影可以对乳腺腺病的诊断及鉴别诊断提供更多的依据,有助于提高超声诊断信心.
목적 분석유선국조성선병적초성조영표현,탐토초성조영재유선선병진단급감별진단중적응용개치.방법 회고성분석110례경수술병리증실적유선선병환자적상규초성급초성조영자료,관찰기록종괴적초성조영특정,분석종괴적조영증강모식、변계특정급시간-강도곡선.결과 110례중상규초성검출151개병조,진단위선병혹선병류61례,진단부합솔40.4％(61/151).초성조영진단위선병혹선병류106례,진단부합솔70.2％(106/151),고우상규초성.실시초성조영증강특점위:재조영제관주체봉시,103개병조(68.2％)이정체혹부분불균균증강위주.121개병조(80.1％)증강정도이중등증강혹초고증강위주,소수병조(11.9％,18/151)현시위명현고증강,겁소수병조(7.9％,12/151)위저증강.107개병조(70.9％)재조영제관주체봉시변계흠청석,무포막,여주위배경유선조직구유일정적연속성,기중5개병조재증강후기체적교상규초성현시명현증대,4개병조재조영제관주체봉시변계사정모자상,무규률성;29.1％(44/151)적병조변계교청석.재고증강화등증강적병조중,시간강도곡선형태이“동진동출형”(60/151,39.7％)화“쾌진쾌출형”(65/151,43.0％)위주.결론 유선국조성선병적초성조영도상유일정특정,통과초성조영가이대유선선병적진단급감별진단제공경다적의거,유조우제고초성진단신심.
Objective To analyse appearances of contrast-enhanced ultrasound(CEUS) of breast local adenosis,and to explore the value of CEUS in the diagnosis of the local adenosis of breast.Methods The data of conventional ultrasound and CEUS of local adenosis of breast in 110 cases confirmed by operation and pathology were analysed.The enhancement patterns,border of the lesion,time-intensity curve were evaluated respectively.Results Totally 151 lesions were detected by conventional ultrasound in 110 cases,61 lesions were diagnosed by conventional ultrasound for adenopathy or adenosis tumor,the diagnosis coincidence rate was 40.4％ (61/151).By CEUS,106 lesions were diagnosed as adenopathy or adenosis tumor,the diagnosis coincidence rate was 70.2 ％ (106/151),higher than that of conventional ultrasound.The features of CEUS include:In contrast perfusion time to peak,103 lesions inhomogeneously enhanced in whole or in part (68.2 ％).The enhancement degree of 121 lesions (80.1 ％) were moderate enhancement or slightly high enhancement,a few lesions (11.9％,18/151) showed significantly enhanced,and very few lesions (7.9 ％,12/151) for low enhancement.In contrast perfusion peak,107 (70.9 ％) lesions had less clear boundary,no envelope,and had a certain continuity with the surrounding background breast tissue,in which 5 lesions were showed significantly increased in size by CEUS comparison with conventional ultrasound,and the boundary of 4 lesions was shaped like the burr,no regularity after enhancing.The boundary of 29.1％ (44/151) of the lesion was clear.In the lesions with moderate enhancement or slightly high enhancement,the time-intensity curve mainly displayed "same washin and same wash out" (60/151,39.7 ％) and "fast washin and fast wash-out" (65/151,43.0％).Conclusions CEUS image of focal breast adenosis has certain characteristics.CEUS can provide more evidences in diagnosis and differential diagnosis of breast adenosis,which can help to improve diagnostic confidence.