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Cuiying Li,Haiyan Gong,Lijun Ling,Liwen Du,Tong Su,Shui Wang,Jie Wang.Journal of Biomedical Research,2018,32(3):198-207
Diagnostic performance of contrast-enhanced ultrasound and enhanced magnetic resonance for breast nodules
Received:February 04, 2018  Revised:March 30, 2018
DOI£º10.7555/JBR.32.20180015
Keywords£ºconventional ultrasound, contrast-enhanced ultrasound, breast lesions, BI-RADS, magnetic resonance imaging (MRI), time¨Cintensity curve (TIC), contrast-enhanced magnetic resonance imaging (CE-MRI)
Grant Program£º
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AuthorInstitution
Cuiying Li Departments of Ultrasound, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu , China
Haiyan Gong Departments of Ultrasound, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu , China
Lijun Ling Departments of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu , China
Liwen Du Departments of Ultrasound, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu , China
Tong Su Departments of Ultrasound, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu , China
Shui Wang Departments of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu , China
Jie Wang Departments of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu , China
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Abstract £º
      In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound (US), contrastenhanced US (CEUS), combined US and CEUS and magnetic resonance imaging (MRI) in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve. The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and 91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them (kappa < 0.20). In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.
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