The Application Research Of Contrast-enhanced Ultrasonographic Micro Flow Imaging In Vascular Characteristics Of Breast Lesions

Objective:Observe the vascular characteristics of breast lesions in contrast-enhanced ultrasonographic micro flow imaging,and explore the application value of it in the differentiation of benign and malignant breast lesions.Methods:Retrospective analysis was performed on the contrast-enhanced ultrasonographic micro flow imaging of 125 breast lesions in our hospital from February 2018 to October 2018.Five vascular characteristics of the lesions were observed,including the number of vessels,penetrating vessels,the angle between the main and branches of the vessels,blood vessel orientation and microvascular architecture(blood supply mode and vascular morphology).The vascular characteristics of benign and malignant breast lesions were compared using pathology as the gold standard.Chi-square test was used for comparison of classified data.P<0.05 was considered statistically significant.Blood vessel characteristics were assigned a value according to whether the difference between benign and malignant lesions was statistically significant and the positive predictive value for the diagnosis of malignant breast lesions.When there was no statistical significance between benign and malignant vascular characteristics,the score was 0.When there was statistical significance,score was assigned based on the positive predictive value score,the positive predictive value>80%was assigned to 3,the positive predictive value<20%was assigned to 1,20%<the positive predictive value<80%was assigned to 2.The ROC curve was used to determine the critical value for the diagnosis of vascular characteristics of malignant breast lesions,and the sensitivity,specificity,accuracy,positive predictive value and negative predictive value for the differential diagnosis of benign and malignant breast lesions were calculated.Results:Among the 125 breast lesions,65 were benign(54.2%,65/125)and 60 were malignant(45.8%,60/125).In vascular characteristics of contrast-enhanced ultrasonographic micro flow imaging,the differences of four characteristics between the benign and malignant lesions were statistically significant(P<0.05),including penetrating vessels,the angle between the main and branches of the vessels,vessel orientation,microvascular architecture(blood supply mode and vascular morphology),the differences of the number of blood vessels between benign and malignant lesions have no statistical significance(P=0.059).The vascular characteristics of the positive predictive value≥80%for the diagnosis of malignant breast lesions by contrast-enhanced ultrasonographic micro flow imaging were:the angle between the main and branches of the blood vessels was right angle(83.9%,47/56),a trend center for the vessels(84%,21/25),the architecture was penetrating vascular type(83.3%,5/6),central large vascular type(100%,4/4),and crab-foot type(100%,13/13).The vascular characteristics with positive predictive value ≤20%include:the angle between the main and branches of blood vessels was non-right-angle(18.8%,13/69),the microvascular architecture was non-blood supply type(10%,1/10),peripheral vascular type(2.8%,1/36),non-vascular type(10%,1/10),linear type(5.9%,1/17)and treelike type(3.4%,1/29).Vascular characteristic score>9 was considered to be the critical value for the diagnosis of malignant breast lesions,and the area under the ROC curve was 0.936.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value for the diagnosis of benign and malignant breast lesions were 85.0%,87.7%,86.4%,86.4%and 86.4%,respectively.Conclusion:1.The vascular characteristics of breast lesions can be better display by contrast-enhanced ultrasonographic micro flow imaging.2.When taken score>9 of vascular characteristics as the critical value,contrast-enhanced ultrasonographic micro flow imaging has agood diagnostic efficacy for benign and malignant breast lesions.