目的 探讨实时灰阶超声造影参数(峰值强度及达峰时间)在鉴别乳腺良、恶性病灶中的临床应用价值.方法 采用低机械指数实时灰阶超声造影技术,对106例乳腺病灶(良性54例,恶性52例)进行超声造影.将良、恶性两组的病灶整体、病灶内部高灌注区、低灌注区的峰值强度、达峰时间及良、恶性病灶峰值强度色阶图进行比较.结果 恶性病灶高灌注区的峰值强度明显高于良性病灶(P<0.01),而低灌注区的峰值强度明显低于良性病灶(P＜0.05).恶性病灶中不同感兴趣区的峰值强度比值与良性病灶相比差异有统计学意义(P＜0.05),表现出明显的不均一性.良、恶性病灶达峰时间差异无统计学意义.恶性病灶内部造影剂增强的峰值强度高低不等,色阶图色彩杂乱;而良性病灶中,峰值强度色阶图颜色相对单一,二者差异有统计学意义(P＜0.01).结论 乳腺恶性病灶内部高、低灌注区增强程度差异较良性病灶显著.因此,对于血流丰富程度及整体增强程度接近的乳腺良、恶性病灶,可以通过分析病灶内部中高、低灌注区的增强情况来帮助鉴别诊断.%Objective To explore the clinical value of the peak intensity and time to peak of real-time gray-scale contrast-enhanced ultrasound( CEUS ) in breast lesions. Methods A total of 106 breast lesions ( 54 benign, 52 malignant ) were examined by CEUS. The microbubble contrast media was SonoVue and the contrast tuned imaging technique( CnTI )was used and then the parameters were obtained. The peak intensity and time to peak in different regions were compared( whole lesion、 high perfusion area 、low perfusion area ). Results There was no difference in the time to peak between benign and malignant lesions. No difference in the whole lesion with peak intensity between benign and malignant was found. The peak intensity of high perfusion area was significantly higher in malignant lesion than that in benign one( P ＜ 0. 01 ). While the peak intensity of low perfusion area was significantly lower in malignant lesion than that in benign one( P ＜0. 05 ). Conclusion The inhomogeneous enhancement parameters of malignant breast lesions are more obvious than those in the benign lesions. Therefore the malignant breast lesions from benign lesions with similar degrees of blood flow and enhancement through the inhomogenicity of the enhancement could be differentiated.
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