An Imaging Study On Small Breast Carcinoma

ObjectiveTo explore a parameter for diagnosis of small breast tumor with the hemodynamics detected by Contrast Enhanced Color Doppler Ultrasound.MethodCollected 79 cases of small breast tumors (malignant 45 cases, benign 34 cases), the size of which were within 2cm in diameter to evaluate hemodynamic parameters of tumoral vessels determined by the images of those breast tumors of ultrasound, mammography, pre-and post contrast medium: Arterial Maximum Velocity(Vmax), Resistance Index(RI), blood flow signal density and opacity interval time. Finally, all the above mentioned parameters were controlled by pathological diagnosis.ResultFor Ultrasound the sensitivity, specificity and diagnostic accuracy of the 45 cases small breast tumors is 57.8%(26/45), 82.3%(28/34) and 68.3%(54/79) respectively; for mammography's is 75.5%(34/45), 70.6%(24/34) and 73.4%(58/79) for Color Doppler Ultrasound's is 84.4%(38/45), 85.3%(29/34) and 84.4%(67/79); for contrast enhanced color Doppler Ultrasound's is 93.9%(42/45), 91.2%(31/34), 92.4%5(73/79).The pre- and post-contrast enhanced hemodynamics parameters of the 79 cases small breast tumors are the following:Before contrast medium was injected: in benign group, 82.3% were in Grade 0-1 blood flow, Vmax was 12.02 ± 8.78m/s, RI was 0.73±0.20; in malignant group, 71.1% was in Grade II-III blood flow, Vmax was 20.12± 8.46 cm/s, RI was 0.67± 0.13. There was significant difference in blood flow signal density, PSV between benign and malignant group (P<0.05) but no significant difference in RI (P>0.05). After contrast medium was injected, in benign group, 84.3% was in Grade O-II blood flow, Vmax was 11.4±8.94cm/s, RI was 0.75±0.19; in malignant group, 82.3% was in Grade III-IV blood flow, Vmax was 19.45±5.91cm/s, RI was 0.71±0.16. There was significant difference in blood flow signal density, Vmax between benign and malignant group (P<0.05) but no significant difference in RI (P>0.05). There was also significant difference in blood flow signal density (P<0.05) but no significant difference in Vmax and RI (P>0.05) between pre- and post-contrast medium injection in malignant group. After contrast medium was injected, the opacity interval time of benign and malignant groups were 274±148s and 132±44s respectively and there was significant difference between two groups (P<0.05). The detection of hemodynamics by Contrast Enhanced Color Doppler Ultrasound is more sensitive, specific and accurate than by traditional ultrasound, mammography and Color Doppler Ultrasound in the diagnosis of small breast tumor(P<0.05).DiscussionUltrasound Contrast Medium can enhance detection rate of tumor blood flow, reflect the blood supply of tumor more accurately, especially in tumor with low velocity and hypo-vascularity and help the differential diagnosis of benign and malignant tumor.