探讨超声造影在诊断伴导管扩张的乳腺病变中的应用价值。

回顾性选取2016年10月至2018年10月在苏州大学附属第一医院就诊、经常规超声及超声造影明确为伴导管扩张的乳腺病变患者65例，所有患者均行手术或穿刺活检取得病理结果。通过超声造影判断扩张导管内是否存在实质性病灶，超声医师分别于造影前、后进行诊断信心评分；并依据病理结果，对良、恶性实质性病灶的超声造影特征进行对比分析。

65个扩张导管内，无实质性病灶的13个，有实质性病灶的52个（其中良性病变32个，恶性病变20个）。超声造影后判断导管内是否存在实质性病灶的诊断信心指数明显提高，与造影前信心指数比较差异有统计学意义（P=0.000）。导管内恶性病灶多表现为增强后病灶周围有滋养血管、增强后前后径增大及增强后病灶边缘不光整，相较于导管内良性病变差异均有统计学意义（P=0.006、0.002、0.000）。

超声造影可以提高导管内实质性病变的诊断信心指数，有助于乳腺导管内实质性病灶良恶性的鉴别，可为伴导管扩张的乳腺病变的术前诊断及手术方式的选择提供有价值的信息依据。

To assess the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of breast lesions with ductal dilatation.

A retrospective analysis was performed on the CEUS data and pathological data of 65 breast lesions with ductal dilatation. All of the 65 patients were enrolled at the First Affiliated Hospital of Soochow University from October 2016 to October 2018. All patients were operated or punctured to obtain pathological results. CEUS was used to determine the presence or absence of solid lesions in dilated ducts, and the enhancement degree, homogeneity, anterior and posterior diameters, feeding vessels, and enhanced margins of the solid lesions were observed.

Among 65 dilated ducts, 13 had no solidlesions and 52 had solidlesions (32 benign lesionsand 20 malignant lesions). After CEUS examination, the diagnostic confidence index of judging whether there were solid lesions in the duct increased significantly (P=0.000). Malignant intraductal lesions were characterized by feeding vessels around the lesions, enlargement of anterior and posterior diameters, and irregular margins of the lesions after enhancement, which differed significantly compared with those of benign intraductal lesions (P=0.006, 0.002, and 0.000, respectively).

CEUS can improve the diagnostic confidence index for intraductal parenchymal lesions and effectively diagnose benign and malignant lesions in the duct.