The Exploratory Development Of Contrasted Ultrasound In Breast Disease

Master Candidate: Huang Lihua Supervisor: Prof.Zong ShaoyunPurpose: Make use of the contrasted ultrasound to research the blood vessel morphologicalcharacter,hemodynamic,the infusing characteristic of contrast agent, the infusingquantitative analysis curve etc. of the breast pathological changes before and after theimaging, the key lies in the discussion of the clinical value of the contrasted ultrasound indifferential diagnosis between hyperplasia of mammary glands and Atypical hyperplasia,benign and malignant tumor.Materials and Methods:Totally 68 focuses of benign and malignant changes of breast, size: 0．6-5．0cm.AII is thefemale, 12～57 years old. Before the technique ,they had not accepted any treatment and allcases had the X ray,the general ultrasound and the contrasted ultrasound before theoperation, and acquired the surgery and pathology confirmation. In which mammaryglands general hyperplasia 12 examples (adenopathy for dominant mode 5 examples, cystfor dominant mode 5 examples, fibro adenoma type structure for dominant mode 2examples), milk accumulated cyst 2 examples, plasma cell mastitis 1 example, chronicmastitis 1 example, mammary gland abscess 1 example, to combine heavy degree Atypicalhyperplasia 12 examples; benignity 23 examples; Fibro adenoma 21 examples, intraductalpapilloma 2 examples; Malignant 16 examples, infiltrating ductal carcinoma 8 examples,lobular carcinoma in situ 6 examples, carcinoma simplex 2 examples.Adopt AcusonSequoia512 color Doppler ultrasonoscope, matched with contrast pulsesequencing (CPS) imaging technique and time strength analysis software: Axius automatictracking contrast quantification (Axius ACQ) software. The acoustic contrast agent ofcompany of Bracco, Sonovue .infused into 5 ml of normal saline before usage, prepares tobe SF6 micro vesicle soliquoid.Carry on rout color Doppler ultrasonography first, to observe the blood appearance,distribute, quantity of the inner and periphery part and look for the richest section of theblood stream, calculate the blood vessel number. Take the most remarkable bloodstream ofthe interior and peripheral with PW to judge the blood signal nature, observe the bloodflow frequency spectrum shape, carry on the spectral analysis, get out the blood streamdynamics parameters: peak value speed of flow (Vmax), the resistance index (Rl), takeaverage values of three times.Then infuse into the contrast agent, simultaneously observe the characteristic of infusing,Exit this condition and enter CDFI and CDE, recording volume of blood flow, thedistributed situation, Carry on pulse Doppler to take a sample of the blood stream whichnewly appears. The peak value speed of flow, the resistance index of the bloodstream of focus after the infusing, similarly surveys 3 times, take the mean value. Use time strengthcurve analysis software to carry on the quantitative analysis to the primary data, combinewith pathologic result as a check to look for its regulation.Results:[1] The initial stage of infusion of most benign focus is the edge type or centripetal type, thepeak of infusion is of even wreath form or spread ,the malignant focus is much for unitytype or centrifuge type, the peak is of uneven or regiment form strengthen.[2] It is unity type that a deep degree atypical hyperplasia infused in the initial stage, thepeak for uneven strengthen.[3] The curve of benign focus is a blunt peak form, the upslope is slow-moving or comparedsteep, the decent is gently and monophase.[4] The curve of malignant focus and deep degree atypical hyperplasia is an overshoot form,the start segment becomes the angulation, the upslope is steep, the decent is comparedgently and monophase or multi-peak.[5] The PI and the slope rate of benign set are all lower than that of malignant set, the ATvalue is higher than malignant set, the TTP; the TTP-AT value is obvious higher thanmalignant set.[6] The PI and the slope rate of general hyperplasia of mammary glands are all lower thanthat of deep degree atypical hyperplasia, the TTP, the TTP-AT value is obvious higher thandeep degree atypical hyperplasia, and the AT has no statistics difference between them.[7] The detection rate of blood flow increases after infusing. The branch, the penetratingblood stream is more obvious after enhancement, but there is no obvious differencebetween the benign and malignant disease of breast in the degree of enhanced blood signal,but between hyperplasia of mammary glands and Atypical hyperplasia is distinct, the latteris obviously higher than the former.[8] There is no obvious difference in distinguishing between the benign and malignantdisease of breast, as well as between general hyperplasia of mammary glands and atypicalhyperplasia in the variety of hemodynamic parameter Vmax, RI before and after theenhancement.Conclusions: The contrasted ultrasound of mammary glands can show the microcirculationinfusion and shape and distribution of new vessels in breast illness more effectively. There isobvious difference between hyperplasia of mammary glands and Atypical hyperplasia,benign and malignant disease on the initial stage,peak value of infusion ,time strengthcurve appearance and the parameters. We thought on these grounds it will contain certainsignificance in discrimination of hyperplasia of mammary glands and atypical hyperplasia, aswell as early diagnosis of breast cancer. It may provide more scientific bases for the clinicaltreatment and the prognosis judgment.