探讨常规超声联合超声造影（CEUS）在不同超声分组乳腺囊实性复合肿块良恶性鉴别中的应用价值。

回顾性选取2017年4月至2019年11月苏州大学附属第一医院收治的乳腺囊实性复合肿块患者111例，共计111个乳腺病灶。根据肿块内部囊实性成分比例及分布特点将其分为3组［A组：厚壁和（或）厚分隔；B组：囊性为主；C组：实性为主］。结合病理分析各组肿块的常规超声及超声造影声像图特征。

111个乳腺病灶中，A组病灶28个（良性24个，恶性4个），B组病灶36个（良性28个，恶性8个），C组病灶47个（良性29个，恶性18个）。B、C组恶性肿块的年龄及最大径均大于良性组，差异均有统计学意义（P均＜0.05）。A组肿块CEUS后恶性肿块多表现为边缘不光整、壁和（或）分隔增厚，与良性肿块比较差异均有统计学意义（P=0.004、0.016）。B、C组恶性肿块多表现为常规超声及CEUS后实性边缘不光整、实性成分增强范围超出基底部，与良性肿块比较差异均有统计学意义（P均＜0.05）。C组良性肿块与恶性肿块间形态、后方回声、有无钙化及血供情况比较，差异均有统计学意义（P均＜0.05）。

常规超声联合CEUS对乳腺囊实性复合肿块的良恶性鉴别具有重要意义，可为临床评估提供可靠的诊断依据。

To evaluate the value of conventional ultrasound combined with contrast-enhanced ultrasound (CEUS) in differentiating benign from malignant complex cystic and solid breast masses in different ultrasonic subgroups.

A total of 111 patients with 111 complex cystic and solid breast masses admitted to the First Affiliated Hospital of Soochow University from April 2017 to November 2019 were retrospectively selected. The lesions were divided into three groups according to the proportion and distribution of cystic/solid components (Group A: thick outer wall and/or thick internal septa; Group B: predominantly cystic component; Group C: predominantly solid component). Based on pathological results, the sonographic features of conventional ultrasound and CEUS in each group were analyzed.

Among the 111 breast lesions, 28 were classified into group A (24 benign lesions, 4 malignant lesions), 36 in group B (28 benign lesions, 8 malignant lesions), and 47 in group C (29 benign lesions, 18 malignant lesions). The patient age and maximum diameter of malignant masses in groups B and C were significantly greater than those in benign masses (P＜0.05 for all). In group A, most malignant masses had no smooth margin and thicker wall/septum on CEUS, with statistically significant differences from benign masses (P＜0.05). In groups B and C, malignant masses were usually characterized by rough solid margin (both on conventional ultrasound and CEUS) and the enhancement range of solid components beyond the basilar part, with statistically significant differences from benign masses (P＜0.05). The differences in shape, posterior echo, calcification, and blood supply between benign and malignant masses in Group C were statistically significant (P＜0.05 for all).

Conventional ultrasound combined with CEUS is of great significance in differentiating benign and malignant complex cystic and solid breast masses, which can provide a reliable diagnostic basis for clinical evaluation.