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

Purpose: To investigate the characteristics of breast neoplasms on contrast-enhanced ultrasonography (CEUS) and its clinical value.

Materials and methods: 225 female patients with breast masses unable to be diagnosed by conventional ultrasonography were examined with CEUS and compared with the results of pathology examination. Ages range were 12 to 85 years (mean age, 45.8 ± 17.6). The process of CEUS was divided into three phases, early (after injection to 1 min), medium-term (1 to 4 min) and late (4 to 6 min). The characteristics of breast neoplasms on CEUS imaging were investigated from 8 aspects, including lesions shapes, boundary of the enhanced lesions, etc..

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.