目的 探讨乳腺癌超声造影特征及定量参数的诊断价值.方法 选取2016年3月至2018年9月青海省第五人民医院收治的乳腺肿块患者247例作为研究对象,其中恶性病变79例,良性病变168例.所有患者均行超声造影检查,比较良性病变与恶性病变的超声造影特征和定量参数的差异.结果 恶性病灶中外形不规则、造影剂分布不均匀、廓清模式造影剂无滞留、血管走行不规则、造影剂快进快出比例均大于良性病灶,差异均有统计学意义(均P < 0.05) .恶性病灶峰值强度高于、达峰时间快于、梯度大于良性病灶[(9.2 ± 1.8) MPa比(5.8 ± 1.7 ) MPa、(19.8 ± 3.4 ) min比(27.0 ± 4.9 ) min、(0.87 ± 0.12) min比(0.57 ± 0.14) min],差异均有统计学意义(均P < 0.01) .多因素Logistic回归分析结果表明,峰值强度(比值比= 1.864,95％ 置信区间: 1.212 ～ 2.761,P < 0.001) 和达峰时间(比值比=1.567,95％ 置信区间: 1.028 ～ 2.135,P = 0.006) 为乳腺癌的相关因素.结论 乳腺癌超声造影结合定量参数诊断具有重要价值,达峰时间和峰值强度对乳腺癌诊断价值较大,乳腺癌病灶参数通常表现为峰值强度高,达峰时间短.%Objective To explore the characteristics of contrast-enhanced ultrasonography and the value of ultrasonic quantitative parameters in the diagnosis of breast cancer. Methods From March 2016 to September 2018,247 patients with breast tumor,including 79 malignancies and 168 benign lesions were enrolled in the Fifth People' s Hospital of Qinghai Province. Ultrasonic manifestations and quantitative parameters were analyzed between benign and malignant tumors. Results Malignant tumors showed more irregular shape,non-uniform distribution and no retention of contrast-media,irregular vascular distribution,fast-in and fast-out of contrast-media than benign tumors(all P < 0.05). Peak intensity,time to peak and gradient of malignant tumors were higher /shorter /greater than those of benign tumors[(9.2 ± 1.8) MPa vs (5.8 ± 1.7) MPa,(19.8 ± 3.4) min vs (27.0 ± 4.9) min,(0.87 ± 0.12) min vs (0.57 ± 0.14) min](all P < 0.01). Multivariate logistic regression showed that peak intensity(odds ratio = 1.864,95％ confidence interval: 1.212-2.761,P = < 0.001) and time to peak(odds ratio = 1.567,95％ confidence interval: 1.028-2.135,P = 0.006) were related with breast malignant tumor. Conclusion Contrast-enhanced ultrasonography and quantitative parameters have great diagnostic values for breast cancer; high peak intensity and short time to peak suggest the malignancy.
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