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Abstract
To evaluate the significance of contrast-enhanced ultrasound (CEUS) examination in
differential diagnosis of malignant and benign breast lesions.
Seventy-one patients with seventy-six breast tumors are selected randomly. CEUS examinations
were performed before and after bolus injection of the contrast agent SonoVue (Bracco,
Milan, Italy). Specific sonographic quantification software, Qontrast, was adopted
to determine the morphology of vessels. Wash-in and wash-out parameters of each lesion
were assessed for both procedures.
The final histopathological findings distinguished 45 malignant and 31 benign from
all of the lesions. Following SonoVue administration different perfusion phases could
be identified: early (0-1min), mid (1-4min) and late (4-6min) phases. In the early
phase, CEUS identified 91.1% of malignant tumors characterized by a claw-shaped enhancement,
while 83.9% of benign tumors had a homogeneous enhancement, with a statistically significant
difference between the two enhancement patterns (chi(2)=43.16, P<0.01). Moreover,
contrast medium persistence in the late phase was helpful in the identification of
benign and malignant tumors (chi(2)=46.88, P<0.01): contrast medium was present in
88.9% of malignant tumors, while in only 9.7% of the benign tumors. The study showed
that various parametric imaging color maps for peak intensity and time to peak were
mostly suggestive of malignancy, while quite uniform peak intensity and time to peak
of color maps were the characteristic of benign tumors. The study also found that
malignant lesions presented with a higher maximum intensity signal than benign ones
(P<0.05) on the time-intensity curves.
CEUS cooperating with conventional US shows improved accuracy in differentiating between
malignant and benign breast tumors. It could be a reliable diagnostic method of breast
lesions.
Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.