乳腺良恶性肿块的不同超声检查图像特征及鉴别诊断效果的临床分析
|
摘要
目的分析乳腺良恶性肿块的不同超声图像特征及鉴别诊断效果。方法回顾性分析71例乳腺肿块患者的临床资料,所有患者均接受常规超声、超声造影以及三维超声成像检查,比较良恶性乳腺肿块的超声检查图像特征。以穿刺活检病理或者术后病理结果作为金标准,比较不同超声检查的诊断效能。结果 71例乳腺肿块患者中,共检出肿块78个,其中恶性肿块31个(39.74%),良性肿块47个(60.26%);恶性肿块不均匀增强比例、"汇聚征"比例分别为70.97%(22/31)和80.65%(25/31),均明显高于良性肿块的19.15%(9/47)和17.02%(8/47),差异均有统计学意义(P﹤0.01);恶性肿块造影剂到达时间、达峰时间、消退时间均明显短于良性肿块,峰值强度明显高于良性肿块,差异均有统计学意义(P﹤0.01);联合检查的准确度为92.31%,高于常规超声、超声造影以及三维超声成像单独检查的80.77%、76.92%和82.05%,差异均有统计学意义(P﹤0.05)。结论乳腺良恶性肿块的超声检查图像特征不同,在常规超声检查的基础上联合超声造影以及三维超声成像检查,可提高乳腺癌的诊断率。
Objective To analyze the different ultrasonographic features of benign and malignant breast masses and the effect of differential diagnosis. Method The clinical profiles of 71 cases with breast masses, who underwent conventional ultrasound, contrast-enhanced ultrasound and three-dimensional ultrasound imaging, were retrospectively analyzed,the ultrasonographic features of benign and malignant breast masses were compared; with the biopsy or postoperative pathological results as the gold standard, the diagnostic efficacy of different ultrasonography were compared. Result There were 78 masses detected in the 71 patients, in which 47(60.26%) were benign and 31(39.74%) were malignant; in malignant masses, the proportion of heterogeneous enhancement and converging sign were 70.97%(22/31) and 80.65%(25/31), respectively, which were significantly higher than those of 19.15%(9/47) and 17.02%(8/47) of benign tumors,with statistically significant difference observed(P<0.01); the arrival time, time to peak concentration and wash out time of contrast agents in malignant masses were significantly shorter than those in benign masses, and the peak intensity was significantly higher than that in benign masses, the differences were statistically significant(P<0.01); the accuracy of the combined examination was 92.31%, and was significantly higher than that of conventional ultrasound, contrast-enhanced ultrasound and three-dimensional ultrasound examination at 80.77%, 76.92% and 82.05%, respectively, demonstrating statistically significant differences(P<0.05). Conclusion Ultrasound examination is exclusively characterized for benign and malignant masses, the combined detection of contrast-enhanced ultrasound and three-dimensional ultrasound imaging in addition to conventional ultrasound can further increase the diagnostic rate of breast cancer.
Objective To analyze the different ultrasonographic features of benign and malignant breast masses and the effect of differential diagnosis. Method The clinical profiles of 71 cases with breast masses, who underwent conventional ultrasound, contrast-enhanced ultrasound and three-dimensional ultrasound imaging, were retrospectively analyzed,the ultrasonographic features of benign and malignant breast masses were compared; with the biopsy or postoperative pathological results as the gold standard, the diagnostic efficacy of different ultrasonography were compared. Result There were 78 masses detected in the 71 patients, in which 47(60.26%) were benign and 31(39.74%) were malignant; in malignant masses, the proportion of heterogeneous enhancement and converging sign were 70.97%(22/31) and 80.65%(25/31), respectively, which were significantly higher than those of 19.15%(9/47) and 17.02%(8/47) of benign tumors,with statistically significant difference observed(P<0.01); the arrival time, time to peak concentration and wash out time of contrast agents in malignant masses were significantly shorter than those in benign masses, and the peak intensity was significantly higher than that in benign masses, the differences were statistically significant(P<0.01); the accuracy of the combined examination was 92.31%, and was significantly higher than that of conventional ultrasound, contrast-enhanced ultrasound and three-dimensional ultrasound examination at 80.77%, 76.92% and 82.05%, respectively, demonstrating statistically significant differences(P<0.05). Conclusion Ultrasound examination is exclusively characterized for benign and malignant masses, the combined detection of contrast-enhanced ultrasound and three-dimensional ultrasound imaging in addition to conventional ultrasound can further increase the diagnostic rate of breast cancer.
引文
[1]杜珍,陆倍倍,张沂.乳腺癌的治疗进展[J].海军医学杂志, 2007, 28(4):367-369.
[2]梁平,赖胜坤,何立红,等.超声综合检查对乳腺癌筛查的临床诊断价值分析[J].医学影像学杂志, 2015, 25(6):1121-1124.
[3]靳凤梅,马苏美,王惠,等.乳腺病灶超声学检查方法的现状与展望[J].中国医学影像技术, 2017, 33(10):1562-1565.
[4]白志勇,张武,苗立英,等.三维超声重建冠状断面检查诊断乳腺良恶性肿物的探讨[J].中国医学影像技术, 2002,18(4):355-357.
[5]智慧,肖晓云,杨海云,等. BI-RADS诊断标准与UE结合对乳腺肿物诊断价值的探讨[J].中国超声医学杂志,2011, 27(4):310-312.
[6]钱小霞,司芩,钱晓莉,等.乳腺癌超声造影特征分析[J].中华超声影像学杂志, 2012, 21(3):217-219.
[7] Uematsu T. Ultrasonographic findings of missed breast cancer:pitfalls and pearls[J]. Breast Cancer, 2014, 21(1):10-19.
[8] Tamaki K, Ishida T, Miyashita M, et al. Breast ultrasonographic and histopathological characteristics without any mammographic abnormalities[J]. Jpn J Clin Oncol, 2012, 42(3):168-174.
[9]周永昌,郭万学.超声医学[M]. 6版.北京:人民军医出版社, 2011:84.
[10]张丽华,赵刚,郭卫东,等.超声弹性成像技术及三维成像技术对乳腺肿块诊断的应用价值[J].河北医药, 2012,11(34):1635-1636.
[11] Xu G, Han T, Yao MH, et al. Three-dimensional ultrasonography for the prediction of breast cancer prognosis[J].J BUON, 2014, 19(3):643-649.
[12] Jiang J, Chen YQ, Xu YZ, et al. Correlation between threedimensional ultrasound features and pathological prognostic factors in breast cancer[J]. Eur Radiol, 2014, 24(6):1186-1196.
[13] B?cker W. WHO classification of breast tumors and tumors of the female genital organs:pathology and genetics[J]. Verh Dtsch Ges Pathol, 2002, 86:116-119.
[14]帕丽达·帕尔哈提,巴妍·谢开,马媛媛,等.超声造影技术与三维超声成像对乳腺良恶性结节的鉴别诊断价值[J].实用癌症杂志, 2016, 31(7):1091-1093.
[15]刘军,司芩,钱晓莉,等.乳腺良恶性肿块的超声造影与弹性成像对比分析[J].临床肿瘤学杂志, 2016, 21(3):262-265.
[2]梁平,赖胜坤,何立红,等.超声综合检查对乳腺癌筛查的临床诊断价值分析[J].医学影像学杂志, 2015, 25(6):1121-1124.
[3]靳凤梅,马苏美,王惠,等.乳腺病灶超声学检查方法的现状与展望[J].中国医学影像技术, 2017, 33(10):1562-1565.
[4]白志勇,张武,苗立英,等.三维超声重建冠状断面检查诊断乳腺良恶性肿物的探讨[J].中国医学影像技术, 2002,18(4):355-357.
[5]智慧,肖晓云,杨海云,等. BI-RADS诊断标准与UE结合对乳腺肿物诊断价值的探讨[J].中国超声医学杂志,2011, 27(4):310-312.
[6]钱小霞,司芩,钱晓莉,等.乳腺癌超声造影特征分析[J].中华超声影像学杂志, 2012, 21(3):217-219.
[7] Uematsu T. Ultrasonographic findings of missed breast cancer:pitfalls and pearls[J]. Breast Cancer, 2014, 21(1):10-19.
[8] Tamaki K, Ishida T, Miyashita M, et al. Breast ultrasonographic and histopathological characteristics without any mammographic abnormalities[J]. Jpn J Clin Oncol, 2012, 42(3):168-174.
[9]周永昌,郭万学.超声医学[M]. 6版.北京:人民军医出版社, 2011:84.
[10]张丽华,赵刚,郭卫东,等.超声弹性成像技术及三维成像技术对乳腺肿块诊断的应用价值[J].河北医药, 2012,11(34):1635-1636.
[11] Xu G, Han T, Yao MH, et al. Three-dimensional ultrasonography for the prediction of breast cancer prognosis[J].J BUON, 2014, 19(3):643-649.
[12] Jiang J, Chen YQ, Xu YZ, et al. Correlation between threedimensional ultrasound features and pathological prognostic factors in breast cancer[J]. Eur Radiol, 2014, 24(6):1186-1196.
[13] B?cker W. WHO classification of breast tumors and tumors of the female genital organs:pathology and genetics[J]. Verh Dtsch Ges Pathol, 2002, 86:116-119.
[14]帕丽达·帕尔哈提,巴妍·谢开,马媛媛,等.超声造影技术与三维超声成像对乳腺良恶性结节的鉴别诊断价值[J].实用癌症杂志, 2016, 31(7):1091-1093.
[15]刘军,司芩,钱晓莉,等.乳腺良恶性肿块的超声造影与弹性成像对比分析[J].临床肿瘤学杂志, 2016, 21(3):262-265.