刘赫;姜玉新;戴晴;朱庆莉;张璟;
LIU He;JIANG Yu-xin;DAI Qing;ZHU Qing-li;ZHANG Jing;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

• 1:中国医学科学院北京协和医学院北京协和医院超声医学科

摘要(Abstract)：

目的探讨超声造影对乳腺导管内乳头状瘤的诊断价值。方法回顾性分析2011年8月至2012年3月在北京协和医院进行乳腺手术的96例患者共96个病灶的超声造影,其中经病理证实为导管内乳头状瘤11例。超声造影增强形式分为无增强、周边增强、均匀增强、区域增强和不均匀增强,分析导管内乳头状瘤的造影特征,并与病理所见进行对照。结果 11例导管内乳头状瘤经常规超声仅检出6例,病灶1.6³.9 cm;经超声造影发现另外4例,均为均匀增强,病灶0.53.9 cm;经超声造影发现另外4例,均为均匀增强,病灶0.5¹.2 cm。11例导管内乳头状瘤中,均匀增强6例(54.5%),区域增强4例(36.4%),无增强1例(9.1%)。超声造影增强区组织病理学特点是扩张导管内乳头状突出物,以纤维血管为轴心,树枝样生长,提示导管内乳头状瘤;非增强区组织病理学特点主要是扩张导管和纤维组织。结论乳腺导管内乳头状瘤超声造影主要为均匀增强和区域增强,超声造影表现与组织病理学特征有关。超声造影有助于提高常规超声对导管内乳头状瘤的检出率。
Objective To evaluate the usefulness of contrast-enhanced ultrasound( CEUS) in the diagnosis of breast intraductal papilloma.Methods CEUS was performed after administration of sulphur hexafluoride microbubbles( SonoVue) in 96 patients scheduled for surgical tumor removal among whom 11 were histologically confirmed to be intraductal papillomas.The enhancement morphologies were classified as non-enhancement,peripheral enhancement,homogeneous enhancement,regional enhancement,and heterogeneous enhancement.The histologic slides were reviewed and compared with CEUS findings.Results Of all 11 intraductal papillomas,6 cases were detected by routine ultrasound and the sizes of lesions were 1.6-3.9 cm; 4 cases were detected by CEUS with a mode of hemogeneous enhancement,and the sizes of lesions were 0.5-1.2 cm.Homogeneous enhancement,regional enhancement,and non-enhancement were found in 6 cases( 54.5%),4 cases( 36.4%),and 1 case( 9.1%),respectively.The contrast enhanced area corresponded to the intraductal papiloma,whereas the non-enhanced area corresponded to the ductal ectasis,fibrosis.Conclusion Intraductal papilloma mainly shows homogeneous or regional enhancement,and the CEUS findings correlate with histologic features.

关键词(KeyWords)： 导管内乳头状瘤,乳腺;超声造影;病理
intraductal papilloma,breast;contrast-enhanced ultrasound;pathology

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(30900372)

作者(Authors): 刘赫;姜玉新;戴晴;朱庆莉;张璟;
LIU He;JIANG Yu-xin;DAI Qing;ZHU Qing-li;ZHANG Jing;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

参考文献(References)：

• [1]Du J,Wang L,Wan CF,et al.Differentiating benign fromalignant solid breast lesions:combined utility of conventional ultrasound and contrast enhanced ultrasound in comparison with magnetic resonance imaging[J].Eur J Radiol,2012,33:3890-3899.
• [2]Du WH,Liu LJ,Wang H,et al.The Clinical significance of real-time contrast enhanced ultrasonography in the differential diagnosis of breast tumor[J].Cell Biochem Biophys,2012,63:117-120.
• [3]刘赫,姜玉新,刘吉斌,等.超声造影增强形式对乳腺病变的诊断价值[J].中华超声影像学杂志,2009,18:414-417.
• [4]Liu H,Jiang YX,Liu JB,et al.Evaluation of breast lesions with contrast-enhanced ultrasound using the microvascular imaging technique:initial observations[J].Breast,2008,17:532-539.
• [5]Wan CF,Du J,Fang H,et al.Evaluation of breast lesions by contrast enhanced ultrasound:qualitative and quantitative analysis[J].Eur J Radiol,2012,81:e444-e450.
• [6]Nakahara H,Namba K,Watanabe R,et al.A comparison of MR imaging,galactography and ultrasonography in patients with nipple discharge[J].Breast Cancer,2003,10:320-329.
• [7]Wenkel E,Janka R,Uder M,et al.Does direct MR galactography have the potential to become an alternative diagnostic tool in patients with pathological nipple discharge?[J].Clin Imaging,2011,35:85-93.
• [8]Sorelli PG,Cosgrove DO,Svensson WE,et al.Can contrastenhanced sonography distinguish benign from malignant breast Masses?[J].J Clin Ultrasound,2010,38:177-181.
• [9]刘赫,姜玉新,刘吉斌,等.乳腺病变超声造影微血管显像增强形式:与病理对照观察[J].中国医学影像技术,2009,25:783-785.