摘要
目的探讨伴髓样特征的乳癌超声造影特征。方法选取2017年1月—2020年7月青岛市市立医院普外科收治、行乳房超声造影检查并经手术病理证实的伴髓样特征的乳癌病人36例及乳房纤维腺瘤病人50例,回顾性分析其超声造影特征。结果36例伴髓样特征的乳癌病人中35例常规超声表现与乳房纤维腺瘤相似。伴髓样特征的乳癌病人超声造影均表现为快进慢退离心性不均匀性高增强,边缘伴毛刺,范围较常规超声扩大(平均4 mm),周边可见汇聚征,其中5例伴有充盈缺损;而38例乳房纤维腺瘤病人超声造影表现为等进快退均匀性向心性等增强,边缘清晰,范围较常规超声无明显扩大,周边未见汇聚征,未见充盈缺损。超声造影定量分析显示,伴髓样特征的乳癌病灶的造影剂灌注初始时间(IT)和最大峰值到达时间(PT)值较同水平正常乳房组织低,造影峰值强度(PI)值较同水平正常乳房组织高,差异有统计学意义(t=2.65~3.76,P<0.05);乳房纤维腺瘤病灶的IT和PT值较同水平正常乳房组织低,PI值较同水平正常乳房组织高,但差异无统计学意义(P>0.05)。结论伴髓样特征的乳癌与乳房纤维腺瘤在常规超声图像上有相似性,但两者的超声造影表现不尽相同,因而对于此种类型的病变术前进行超声造影检查,可提供更多的诊断信息。
Objective To investigate the contrast-enhanced ultrasound features of breast cancer with medullary features.Methods A retrospective analysis was performed for the contrast-enhanced ultrasound features of 50 patients with breast fibroadenoma and 36 breast cancer patients with medullary features who were admitted to Department of General Surgery,Qingdao Muni-cipal Hospital,from January 2017 to July 2020,underwent contrast-enhanced ultrasound,and were confirmed by postoperative pathology.Results Among the 36 breast cancer patients with medullary features,35 had similar findings as breast fibroadenoma on conventional ultrasound.The breast cancer patients with medullary features showed eccentric heterogeneous hyperenhancement with fast wash-in and slow wash-out on contrast-enhanced ultrasound,with spiculation on the edge and a larger extent(mean 4 mm)than that on conventional ultrasound,and convergence sign was observed in surrounding areas;among these patients,5 were found to have filling defects.The 38 patients with breast fibroadenoma showed concentric homogeneous iso-enhancement with equal wash-in and fast wash-out on contrast-enhanced ultrasound,with a clear edge and no obvious extension compared with that on conventional ultrasound,and no convergence sign was observed in surrounding areas;in addition,no filling defect was observed.The contrast-enhanced ultrasound quantitative analysis showed that compared with normal breast tissue at the same level,the breast cancer lesion with medullary features had significantly shorter initial time(IT)and peak time(PT)of contrast agent perfusion and a significantly higher peak intensity(PI)(t=2.65-3.76,P<0.05),and the breast fibroadenoma lesion had shorter IT and PT and a higher PI than normal breast tissue at the same level(P>0.05).Conclusion Breast cancer with medullary features has similar conventional ultrasound images to breast fibroadenoma,but there still exist certain differences between them.Therefore,preoperative contrast-enhanced ultrasound should be performed for t
作者
吴凤芸
滕鑫
韩彤亮
类婷婷
刘刚
贾冬梅
WU Fengyun;TENG Xin;HAN Tongliang;LEI Tingting;LIU Gang;JIA Dongmei(Department of Ultrasound, Qingdao Municipal Hospital, Qingdao 266071, China)
出处
《青岛大学学报（医学版）》
2021年第6期928-931,共4页
Journal of Qingdao University(Medical Sciences)
基金
青岛市卫计委卫生科研计划项目(2018-WJZD003)。
关键词
乳房肿瘤
癌
髓样
超声检查
诊断
breast neoplasms
carcinoma,medullary
ultrasonography
diagnosis
