目的 评价超声造影对乳腺导管原位癌的诊断价值.方法 回顾性分析17个乳腺导管原位癌的超声造影形态学增强模式和时间-强度曲线定量参数,并比较常规超声和超声造影对该组肿瘤的诊断准确率.结果 本组17个导管原位癌中,造影增强显示病灶周围扭曲或穿入血管15个(88.2%)、造影剂分布不均匀16个(94.1%)、病灶形态不规则14个(82.4%).超声造影前后肿块的平均大小分别为(27.0±9.4)mm、(31.6±11.8)mm,造影后肿块明显增大(P<0.01).病灶多呈快速高增强,平均达峰时间(17.3±3.9)s、平均峰值强度6.8±2.8.本组乳腺导管原位癌超声造影的诊断准确率达94%(16/17).结论 乳腺导管原位癌具有较典型的恶性造影增强特征.超声造影明显提高了对导管原位癌的诊断准确率,有望成为提高乳腺癌早期诊断率的一个重要手段.%Objective To assess the value of real-time gray scale contrast-enhanced ultrasonography (CEUS) in the diagnosis of breast ductal carcinoma in situ (DCIS). Methods We retrospectively reviewed the contrast-enhanced sonographic findings of all the 17 DCIS histopathologically confirmed,including morphologic features and quantitative parameters. Diagnostic accuracy was then compared between CEUS and conventional ultrasonography(US). Results The 17 DCISs displayed penetrating or tortuous surrounding vessels[ 15(88.2％)], heterogeneous enhancement[ 16 (94.1％ ) ] , irregular shape[14 (82.4％)] on CEUS. The size measurement of all the 17 lesions obviously increased on CEUS (27.0±9.4 mm vs 31.6±11.8 mm,precontrast vs postcontrast)(P＜0.01). The lesions showed quick hyperenhancement on CEUS. Mean peak intensity was 6.8±2.8 and mean time to peak was 17.3±3.9s. DCIS achieved an improved diagnostic accuracy of 94％(16/17). Conclusions DCIS can exhibit typical characteristics of malignant tumor on CEUS. CEUS has the potential of becoming an effective method to improve the accuracy in the diagnosis of the early breast cancer.
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