Breast Lesion Ultrasound Contrast Microvascular Imaging And Pathology Control Study

Partâ… Contrast Enhanced Ultrasonography with MVI in the Diagnosis of Breast LesionsPerpose1.To evaluate the usefulness of CEUS(contrast enhanced ultrasonography) with MVI(micro vascular imaging ) in the diagnosis of breast lesions, and compare it with conventional ultrasound.2. To investigate breast lesions' diagnostic criteria of CEUS with MVI. Materials and methodsIn 104 patients with 104 breast tumors scheduled for surgical tumor removal, CEUS with MVI was performed before and after administration of sonovue. Of the 104 lesions, 60 lesions were benign, 1 lesion was borderline, 43 lesions were malignant.The enhancement pattern on CEUS with MVI images was classified as non, peripheral, homogeneous, regional, or heterogeneous enhancement based on the morphologic features of enhancing areas, and all breast lesions' enhancement patterns were reviewed. In addition, the sensitivity, specificity, PPV(positive predictive value), NPV(negative predictive value) and accuracy were calculated and compared between CEUS with MVI and conventional ultrasound.ResultsNon enhancement was suggestive of benignity with a sensitivity/ specificity/ PPV/ NPV/ accuracy of 18.3%/ 97.7%/ 91.7%/ 46.2%/ 51.5%. Peripheral enhancement was suggestive of malignancy with a sensitivity/ specificity/ PPV/ NPV/ accuracy of 39.5%/ 98.3%/ 94.4%/ 69.4%/ 73.8%. Homogeneous, regional, and heterogeneous enhancement can show histopathologic features.Increased measurement of tumor size(>2mm) afer CEUS with MVI was suggestive of malignancy with a sensitivity/ specificity/ PPV/ NPV/ accuracy of 62. 8%/ 96. 7%/ 93. 1%/ 78. 4%/ 82. 5%.Peripheral enhancement and/or increased measurement of tumor size was suggestive of malignancy with a sensitivity/ specificity/ PPV/ NPV/ accuracy of 76.7%/ 95.0%/ 91.7%/ 85.1%/ 87.3%.ConclusionCEUS with MVI plays major role in breast lesions' diagnosis, and the usefullness is improved when CEUS with MVI and conventional ultrasound are used simutineously. Partâ…¡Contrast Enhanced Ultrasonography with MVI findings of breast lesions : comparison with pathological examinationPerpose1.To investigate the histopathologic bases of breast lesions' enhancement pattern demonstrated on CEUS with MVI images.2. To investigate the correlation of peripheral enhancement in breast cancers with tumor angiogenesis(microvessel density) and expression pattern of VEGF.Materials and methodsIn 104 patients with 104 breast tumors scheduled for surgical tumor removal, CEUS with MVI was performed before and after administration of sonovue. Of the 104 lesions, 60 lesions were benign, 1 lesion was borderline, 43 lesions were malignant.All breast lesions' CEUS with MVI images were reviewed and correlated with histopathologic features. In addition, the peripheral enhancement in breast cancers were correlated with the ratio of peripheral-to-central microvessel density and VEGF expression pattern.Results1. Eenhancing areas are maily carcinoma in situ, actively growing part of invasive carcinoma/ adenosis/ fibroadenoma, intra ductal papiloma, stroma rich in vascularity on pathological examination.2. Tumor increased area after CEUS with MVI are carcinoma in situ, adenosis, lympho-vascular invasion, intra ductal papiloma, or inflammation on pathological examination.3. Peripheral enhancement in breast cancers were not correlated with tumor size, classification, grade, stage, lymphnode metastasis and prognosis.4. The ratio of peripheral-to-central microvessel density and VEGF expression pattern were significantly diffenent between the peripheral enhancement group and the non peripheral enhancement group in breast cancers.Conclusion1. Breast lesions' enhancement pattern can show histopathologic featues.2. Peripheral enhancement in breast cancers correlated with the high ratio of peripheral-to-central microvessel density and peripherally positive/ centrally negative VEGF expression.3. Peripheral enhancement in breast cancers were not correlated with tumor size, classification, grade, stage, lymphnode metastasis and prognosis.