本文選題：超聲造影 + 乳腺腫塊　； 參考：《青海大學(xué)》2014年碩士論文

【摘要】：目的：探討乳腺良惡性腫塊的超聲造影(CEUS)增強模式及其時間-強度曲線（TIC）參數(shù)特征，為乳腺腫塊的早期鑒別診斷提供影像學(xué)依據(jù)。方法：研究對象選自2012年12月至2013年12月青海大學(xué)附屬醫(yī)院擬診為乳腺腫瘤的患者46人，腫塊50個。首先利用常規(guī)二維及彩色多普勒超聲(US)檢查患者并獲得最佳腫塊切面圖像，記錄腫塊的數(shù)目、位置、大小、內(nèi)部回聲，縱橫比及內(nèi)部血流情況；然后切換到造影模式，通過肘正中靜脈快速注射微氣泡超聲造影劑SonoVue5ml，然后推注10ml生理鹽水，觀察造影動態(tài)過程6min,圖像及造影過程存盤并待脫機分析。感興趣區(qū)選定為病灶內(nèi)造影劑灌注分布最強區(qū)域,通過軟件自動繪制時間-強度曲線（TIC）獲取造影峰值時間(TTP),始增時間(AT)、曲線下面積(AUC)及峰值強度(PI)等參數(shù)。及時對患者進行隨訪，并將報告結(jié)果與術(shù)后病理結(jié)果相比較。并對所得數(shù)據(jù)進行統(tǒng)計學(xué)分析處理。 結(jié)果：1、46名受檢者的50個乳腺腫塊中良性腫塊25例，超聲造影特征性表現(xiàn)主要以無增強和均勻增強為主，增強后腫塊邊界多清晰光整，時間-強度曲線主要以快出型多見。2、46名受檢者的50個乳腺腫塊中惡性腫塊25例，造影特征性表現(xiàn)主要以不均勻增強及周邊增強為主,增強后腫塊多邊界不清晰，周邊有穿支血管，，內(nèi)部可見血流灌注缺損,且造影增強范圍比常規(guī)超聲測值增大，時間-強度曲線主要以快進慢型多見。3、良惡性乳腺腫塊造影參數(shù)中始增時間(AT)差異不存在統(tǒng)計學(xué)意義(P〉0.05),而良惡性腫塊間造影的峰值強度(PI)、達(dá)峰時間(TTP)、曲線下面積(AUC)等參數(shù)差異均有統(tǒng)計學(xué)意義(P〈0.05)。結(jié)論：乳腺良惡性腫塊的超聲造影增強模式及其時間-強度曲線參數(shù)特征差異具有統(tǒng)計學(xué)意義，超聲造影有望根據(jù)其進行較為準(zhǔn)確的鑒別診斷，成為一種乳腺腫瘤的術(shù)前無創(chuàng)、快捷的影像學(xué)方法。
[Abstract]:Objective: to investigate the enhanced mode of contrast-enhanced ultrasound (CEUs) and its time-intensity curve (TIC) parameters in benign and malignant breast masses, and to provide imaging evidence for the early differential diagnosis of breast masses. Methods: from December 2012 to December 2013, 46 patients with breast tumors were selected from affiliated Hospital of Qinghai University. First, the patients were examined with conventional two-dimensional and color Doppler ultrasound (USS) and the optimal mass section images were obtained. The number, location, size, internal echo, aspect ratio and internal blood flow of the masses were recorded, and then switched to the contrast mode. The microbubble ultrasound contrast agent SonoVue 5ml was injected quickly through the median elbow vein and then injected with 10ml saline. The dynamic process of the imaging was observed for 6 minutes and the images and the imaging process were saved and analyzed offline. The region of interest was selected as the strongest area of the distribution of contrast media perfusion in the lesion. The parameters such as the peak time and the peak time of TTP, the area under the curve, and the peak intensity were obtained by the software automatic drawing of time-intensity curve (TICs). Patients were followed up in time, and the reported results were compared with postoperative pathological results. The data were analyzed and processed statistically. Results among the 50 breast masses, 25 cases were benign masses. The main features of contrast-enhanced ultrasonography were non-enhancement and homogeneous enhancement, and the margin of the mass was clear and smooth after enhancement. Among 50 breast masses, 25 cases were malignant masses in which the time-intensity curve was mainly fast out of 46 patients. The characteristic features of the enhancement were mainly non-uniform enhancement and peripheral enhancement, and the multi-boundary of the masses was not clear after enhancement. There were perforating vessels around, blood perfusion defects could be seen inside, and the range of contrast enhancement was larger than that measured by conventional ultrasound. The time-intensity curve was mainly fast-forward and slow-type. 3. There was no significant difference of ATT in the parameters of benign and malignant breast masses (P > 0.05), but the peak intensity of contrast imaging between benign and malignant masses was PII, the peak time was TTPT, and under the curve, there was no significant difference between benign and malignant breast masses (P > 0.05). There were significant differences in AUC and other parameters (P < 0.05). Conclusion: contrast-enhanced mode and time-intensity curve parameters of benign and malignant breast masses have statistical significance. Contrast-enhanced ultrasonography is expected to be a noninvasive preoperative diagnosis of breast tumors. Quick imaging methods.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.1;R737.9

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