The Application Value Of Contrast Enhanced Ultrasound For Diagnosing BI-RADS 4 Breast Lesions

Objective:To disscuss the clinical significance of contrast enhanced ultrasound(CEUS)for furtherly diagnosing BI-RADS 4 breast lesions and the key diagnostic indicators of the CEUS.Methods:Totally 92 cases of breast lesions which were classified as BI-RADS 4 before surgical resection or core needle biopsy in The Second Affiliated Hospital of Zhejiang University School of medicine from June 2016 to October 2017 were evaluated by conventional B mode ultrasound and CEUS.The B mode indicators,morphologic enhanced characteristics of CEUS and the time intensity curve(TIC)are analysed and recorded.The significant diagnostic indicators of B mode,CEUS and the combination of the two methods were determined by Pearson Chi-square test,binary logistic regression analysis and Student’s t-test by scoring 0 for benign and 1 for malignant characteristics,using pathology as the referential standard to built the score systems of the three methods.The receiver operating characteristic curve(ROC)were applied to compare the diagnostic efficacy of the three score systems.Results:There are 43 malignant lesions and 49 benign lesions as the pathologic results showing.Binary logistic regression analysis demonstrated that the margin,micro-calcification,and the hyperechoic halo surrounding the mass are the key diagnostic indicators for B mode ultrasound;The enlargement of the diameter after enhancement and the pathological vessels of the lesions are the key indicators for CEUS.The micro-calcification,hyperechoic halo surrounding the mass,the enlargement of the diameter after enhancement and the pathological vessels are indicators for the combination of the two methods.The area under the ROC curve of B mode,CEUS and the combination of the two modes are 0.885,0.901,0.937 respectively.Conclusion:Firstly,CEUS is helpful for furtherly distinguishing BI-RADS 4 breast lesions,improving the diagnostic efficacy of the conventional B mode ultrasound and enhancing the diagnostic confidence of the sonographer.Secondly,the enlargement of the diameter after enchancement and the pathological vessels may be the most important significant indicators for CEUS.Thirdly,the qualitative indicators may be better than the quantitative indicators for predicting the property of the breast lesions.