The Research Of Focal Breast Lesions By Real-time Gray-scale Contrast-enhanced Ultrasonography And Thermal Texture Mapping

Objective To investigate the ultrasonic characteristics and clinical value of real-time gray-scale contrast-enhanced ultrasonography in differentiation of focal breast lesions , meanwhile ,to explore the Thermal Texture Maps(TTM) characteristics and analyze the factors which affect the thermal imaging of focal breast lesions .Methods Adopt Technos DU8 Color Doppler ultrasonoscope, matched with contrast tuned imaging (CnTI) and Wash-in/Wash-out software. The acoustic contrast agent of company of Bracco, Sonovue which infused into 5ml of normal saline before usage, prepares to be SF6 micro vesicle soliquoid. 49 patients with 58 focal breast lesions were examined by conventional ultrasound and real-time gray-scale contrast-enhanced ultrasound (CEUS) before operation. The results of CEUS were compared with those of pathology; and meanwhile, infrared thermal imaging was adapted to examine 21 patients with 21 focal breast lesions (11 breast fibroadenoma and 10 invasive ductal carcinoma ).The thermal related data was obtained, and the thermal distribution characteristic of breast tumor was discussed. Furthermore, the detected results by infrared thermal imaging were compared with those by ultrasonography, and finally the factors of the benign and malignant breast tumor's thermal imaging was analyzed.Results After injection of Sonovue, all lesions were enhanced on real-time ultrasonogram. Three patterns of enhancement were observed according to dynamic enhanced model: no enhanced, peripheral net enhanced and intratumoral enhanced pattern. The pattern of no enhanced or peripheral net enhanced were shown in 66.7 percent of benign lesions(24/36), intratumoral enhanced pattern was shown in 72.7 percent of malignant lesions(16/22).Three types of the time-intensity curve were observed: quick up and slow down multi-platform, slow up and quick down and slow up and quick down low-platform type. The first type of the time-intensity curve was seen in 90.5 percent of malignant lesions(19/21).The others were seen in 83.3 percent of benign lesions(20/24).Abnormal color area in the Thermal Texture Maps(TTM) could be seen in all of 21 patients with 21 focal breast lesions. Abnormal breast thermo-source was irregular morphology(90.0%,9/10) , more vascular(80.0%,8/10) on malignant tumor ,the other way round on benign tumor(81.8%,9/11).And the heat values of the malignant tumor were higher than those of the benign one. The differences of the Thermal Texture Maps(TTM) characteristics between the malignant group and the other one had statistical significance(P<0.05).Conclusions Our study can be concluded that they had a unique ultrasonic characteristics of CEUS and time-intensity curve characteristics of breast fibroadenoma, breast adenosis, invasive ductal carcinoma. CEUS combined with conventional ultrasound can improve the accuracy rate for diagnosing focal breast lesions. So, it has important clinical application value. The metabolic features could be obtained through analyzing the thermal distribution characteristics of breast tumor. Furthermore, the detected results by infrared thermal imaging were compared with those by ultrasonography. The results show that they matched well. Therefore, infrared thermal imaging based on the metabolism of the body is expected to become an effective method for female breast health care or disease early detection. But it demands quantity of cases to improve the quality of breast Thermal Texture maps and summarize the rules of reading maps. This study is very valuable for the early diagnosis of breast diseases.