Characteristics of breast neoplasms on contrast-enhanced ultrasonography and its clinical value

Objective: To investigate the characteristics of breast neoplasms on contrast-enhanced ultrasonography and its clinical value.

Materials and methods: 225 female patients with breast masses unable to be diagnosed by conventional ultrasonography were examined with contrast-enhanced ultrasonography (CEUS). 225 cases were investigated. For cases of multiple lesions, performed which was the highest classification level of BI-RADS; for the lesions of the same level, performed the largest lesion. All the fundamental ultrasound examinations were performed by the Siemens Sequoia Acuson512 or Philips iU22, which were matched with contrast pulse sequence (CPS) imaging technique.

Results: 91 cases were malignant and 134 cases were benign. The 91 malignacies displayed: irregular shapes were 80.2% (73/91), tortuous, massive or penetrating vessels were 86.8% (79/91), heterogeneous distribution of contrast enhancement were 83.5% (76/91),perfusion defect of contrast signals were 89.0% (81/91), local retention of contrast signals were 93.4% (85/91), rapidly entering and exporting from the lesions were 65.9% (60/91). Significant differences of above CEUS characteristics were found between the benign and malignant breast lesions (P < 0.05), The two most important features were perfusion defects and local retention of the contrast signals, with the sensitivity and specificity attained to 89.0% and 91.8%, and 93.4% and 92.5%, respectively. Poorly defined boundaries of the 91 malignacies were 64.8% (59/91), and the specificity was 47.8%. The malignant cases had enlarged maximum diameter on CEUS compared to pre-contrast (P < 0.05).

Conclusion: The typical features of breast cancers on CEUS were irregular shapes, tortuous, massive or penetrating vessels, heterogeneous distribution of contrast enhancement, with perfusion defect or local retention of contrast signals, rapidly entering and exporting from the lesions, enlarged maximum diameter of the lesions on CEUS compared to pre-contrast. It is valuable for CEUS in the diagnosis and differential diagnosis of breast neoplasms clinically.

Key words: breast neoplasms/contrast media/ultrasonography