浙江临床医学
浙江臨床醫學
절강림상의학
ZHEJIANG CLINICAL MEDICAL JOURNAL
2015年
4期
505-506,507
,共3页
龚元淑%梁柏松%卿顺华%薛袁园
龔元淑%樑柏鬆%卿順華%薛袁園
공원숙%량백송%경순화%설원완
乳腺肿瘤%乳腺影像报告和数据系统%超声造影
乳腺腫瘤%乳腺影像報告和數據繫統%超聲造影
유선종류%유선영상보고화수거계통%초성조영
Breast tumor%Breast imaging reporting and data system%Contrast-enhanced ultrasound
目的：评价超声造影对BI-RADS 4级乳腺肿块的进一步鉴别诊断的价值。方法通过分析64个BI-RADS-US 4级乳腺的实时灰阶超声造影征象和时间-强度曲线定量参数（AT、TTP、PI），进行超声造影良恶性鉴别诊断，并与术后病理检查结果进行对照。结果64个BI-RADS-US 4级乳腺肿块，术后病理结果为恶性29个，良性35个，良恶性组间在造影后形态、造影剂分布，边界、周围扭曲或穿入血管、造影后有无明显增大方面差异较明显（P<0.05），而在定量参数中，达峰时间（TTP）和峰值强度（PI）在良恶性组间有较明显差异（P<0.05），本组64个常规超声BI-RADS-US4级乳腺肿块中，造影诊断为恶性32个，良性32个，诊断敏感性89.7%，特异性82.9%，准确率86%。其中对浸润性导管癌、纤维腺瘤的诊断准确性较高。结论超声造影实时灰阶征象结合时间-强度曲线分布可对常规超声BI-RADS4级乳腺肿块进一步良恶性鉴别诊断。
目的：評價超聲造影對BI-RADS 4級乳腺腫塊的進一步鑒彆診斷的價值。方法通過分析64箇BI-RADS-US 4級乳腺的實時灰階超聲造影徵象和時間-彊度麯線定量參數（AT、TTP、PI），進行超聲造影良噁性鑒彆診斷，併與術後病理檢查結果進行對照。結果64箇BI-RADS-US 4級乳腺腫塊，術後病理結果為噁性29箇，良性35箇，良噁性組間在造影後形態、造影劑分佈，邊界、週圍扭麯或穿入血管、造影後有無明顯增大方麵差異較明顯（P<0.05），而在定量參數中，達峰時間（TTP）和峰值彊度（PI）在良噁性組間有較明顯差異（P<0.05），本組64箇常規超聲BI-RADS-US4級乳腺腫塊中，造影診斷為噁性32箇，良性32箇，診斷敏感性89.7%，特異性82.9%，準確率86%。其中對浸潤性導管癌、纖維腺瘤的診斷準確性較高。結論超聲造影實時灰階徵象結閤時間-彊度麯線分佈可對常規超聲BI-RADS4級乳腺腫塊進一步良噁性鑒彆診斷。
목적：평개초성조영대BI-RADS 4급유선종괴적진일보감별진단적개치。방법통과분석64개BI-RADS-US 4급유선적실시회계초성조영정상화시간-강도곡선정량삼수（AT、TTP、PI），진행초성조영량악성감별진단，병여술후병리검사결과진행대조。결과64개BI-RADS-US 4급유선종괴，술후병리결과위악성29개，량성35개，량악성조간재조영후형태、조영제분포，변계、주위뉴곡혹천입혈관、조영후유무명현증대방면차이교명현（P<0.05），이재정량삼수중，체봉시간（TTP）화봉치강도（PI）재량악성조간유교명현차이（P<0.05），본조64개상규초성BI-RADS-US4급유선종괴중，조영진단위악성32개，량성32개，진단민감성89.7%，특이성82.9%，준학솔86%。기중대침윤성도관암、섬유선류적진단준학성교고。결론초성조영실시회계정상결합시간-강도곡선분포가대상규초성BI-RADS4급유선종괴진일보량악성감별진단。
Objective To assess the value of contrast-enhanced ultrasonography(CEUS)in differential diagnosis of BI-RADS 4 breast lesions. Methods The CEUS findings of 64 breast lesions of BI-RADS 4,including morphologic features and time-intensity curve parameters(AT,TTP, PI)were analyzed,and in the end the CEUS diagnoses were made according to our preliminary study results.Histology results were served as golden reference.Results Of all the 64 BI-RADS 4 breast 1esions that were confirmed by histopatho1ogy results,29 were malignant and 35 were benign. The differences of morphologic features of shape,margin,penetrating or tortuous surrounding vessels,heterogeneous or homogeneous distribution, whether the lesion was significant enlarged after contrast enhanced between benign and malignant lesions were with statistical significant(P<0.05). And the diffbrences of the parameters(including TTP,PI)between the benign and malignant lesions were with statistical significant in our study(P<0.05).32 lesions were diagnosed as malignant,while 32 lesions were diagnosed as benign with CEUS.Its sensitivity,specificity and accuracy were 89.7%,82.9% and 86%.In a11 the histological types of these 64 breast 1esions,the diagnostic accuracies for invasive ductal carcinoma,fibroadenoma were relatively higher. Conclusion CEUS could be applied as a useful adjunct to conventional ultrasonography for BI-RADS 4 breast lesions.
