| Objective:Explore the value of ultrasound imaging for differentiating and diagnosis of benign and malignant breast and all the parameters correlation analysis of tumor MVD.Methods:Retrospective analysis of ultrasound in our department from September2010to September2011and confirmed by surgery or biopsy in88cases of breast cancer patients,52cases (malignant and benign36cases) were female. Two-dimensional ultrasound observation of breast tumor location, size, shape, border, internal echo, and the surrounding organization and application of color Doppler flow imaging observation of blood flow and distribution, GE Logiq9color ultrasonic diagnostic apparatus color Doppler real-time ultrasound imaging, image analysis of tumor imaging characteristics and the recording time-intensity curves (time-of Intensity curve, TIC) of parameter values, namely: arrive time (AT, destroy drug to infusion start time), peak time (PT, destroy the drug to the contrast agent to reach the lesion peak time), the peak intensity (PI, the intensity of the curve at the top), the peak half the difference between time (HT, lesions peak half-time the lesions enhance the peak time), ascending branch slope (AS), and analyze the shape of the curve. CEUS diagnostic results were compared with pathological results. Finally, the breast mass postoperative pathologic specimens anti-CD34immunohistochemistry, and microvascular density (MVD) count, and time-intensity curve of each parameter value and microvessel density in the correlation analysis. SPSS16.0software, the variety of data analysis, measurement data (x±s)in the form of groups were analyzed using two sample t-test, correlation test using the Pearson test, P<0.05indicated a statistically significant difference.Results:First, breast lump ultrasound imaging characteristics and TIC curve.1. Breast mass ultrasound contrast image features:contrast-enhanced from the lesion, degree of enhancement, morphology, and enhance border, the contrast agent distribution and whether or not to wear the vessel in benign and malignant lumps were analyzed, the study found that the malignant group was significantly increased78.84%(41/52), enhanced by the irregular shape,84.61%(44/52), enhanced ill-defined80.76%(42/52), wearing a vessel of82.69%(43/52) dominated, while the benign group significantly enhanced by72.22%(26/36),66.66%(24/36) enhanced form of rules, enhanced border clear86.11%(31/36), no wear-vessel83.33%(30/36) dominated. Between the differences were statistically significant (P<0.05). While the overall distribution of the contrast agent in malignant group enhanced by53.84%(28/52), part of the enhanced46.15%(24/52), benign group as a whole enhanced by72.22%(26/36), part of the enhanced27.77%(10/36), two between the difference was not statistically significant.2. TIC curve analysis:the benign group, AT, PT, PI, Tb, K, the average (10.92±3.30),(1736±4.53),(1008±4.13),(31.92±21.67),(0.12±0.06), while the malignant group, AT, PT, PI, Tb, K, the average, respectively (11.35±3.39),(17.83±5.07),(13.9±4.70),(52.58±29.63),(0.14±0.06). The PI of Tb between the difference was statistically significant (P<0.05). AT, PT, K, the difference was not statistically significant (P>0.05)And the study found that the descending branch curve form of benign and malignant group there are also different, decreased90.48%(52/47) and ill group support relatively flat with irregular multi-directional,58.33%(21/36) benign group decreased support compared with steep with one-way rules. The difference was statistically significant (P<0.05).Second, breast tumor MVD and the quantitative parameters of ultrasound contrast TIC correlation analysis. Benign and malignant tumors between MVD difference was statistically significant (P<0.05). The study also found that the higher the degree of malignant transformation, the higher the micro vessel density, the higher the contrast-enhanced strength, namely, breast tumor MVD and ultrasound imaging time-intensity curve quantitative parameters PI was significantly positively correlated (r=0.85, P<0.05), while the breast tumor MVD and the AT and Tb low degree of correlation with PT, K.Third, The results of ultrasonography in the diagnosis in breast lumps. The degree of ultrasound contrast enhancement, enhanced form of enhanced border distribution of contrast agent, whether to wear the sensitivity of the vessel are as follows:78.84%、84.61%、80.76%、53.84%、84.31%; specificity were:72.22%、68.57、86.11%、72.22%、83.33%.Conclusions:First, the breast tumor ultrasound contrast enhancement characteristics and the shape of the time-intensity curve, and differences in various parameters of benign and malignant tumors. Second, the benign and malignant tumors MVD difference statistically significant. And ultrasound contrast-enhanced strength and MVD was significantly positively correlated, can be used as a quantitative basis for evaluation of tumor angiogenesis. Third, ultrasound imaging can help breast tumor benign and malignant differential diagnostic value. |
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