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The diagnostic value of marginal zone enhancement features of contrast-enhanced ultrasound in the benign and malignant breast masses identification of BI-RADS 4 |
CHEN Fei JIA Chunmei LYU Qi WANG Jingjie HU Tian |
Department of Ultrasound, the First Hospital of Shanxi Medical University, Shanxi Province, Taiyuan 030001, China |
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Abstract Objective To explore the diagnostic value of two-dimensional ultrasound (2D-US) and contrast-enhanced ultrasound features in marginal zone for benign and malignant breast masses in BI-RADS 4. Methods From January 2016 to July 2018, 76 patients were collected from the Department of Ultrasound, the First Affiliated Hospital of Shanxi Medical University. A total of 77 breast masses were confirmed by biopsy or surgical pathology. Benign and malignant tumors were divided into two groups. 2D-US and contrast-enhanced ultrasound characteristics of marginal zone in benign and malignant tumors were compared. And the marginal zone and the inside of the masses time-intensity curve (TIC) parameters of the benign and malignant groups were analyzed. Base strength (BI), peak intensity (PI), area under the curve (AUC), peak time (TTP), and gradient (Grad) were observed. They were analyzed for 3 times and the average value was taken. Results Compared with benign group, 2D-US of malignant group showed more irregular edge, spiculate margin, acoustic halo and lobulated edge, the differences were statistically significant (P < 0.05). Contrast-enhanced ultrasound showed radial enhancement, perforator enhancement and circular enhancement, perforation enhancement, unclear boundary, enlarged range after angiography were more common in malignant group, the differences were statistically significant (P < 0.05). In malignant group, BI, PI, AUC and Grad were bigger in marginal zone than the inside of the masses, and TTP was faster than the inside of the mass, the differences were statistically significant (P < 0.05). In benign group, the marginal zone of lesion was not significantly different from the internal mass in the above parameters (P > 0.05). Conclusion There are significant differences between the benign and malignant masses in the 2D-US and contrast-enhanced ultrasound of the marginal zone. The ultrasound signs of the marginal zone of the malignant masses contribute more to the diagnosis of breast cancer than the internal, therefore, focusing on the marginal zone ultrasound characteristics can improve the ability of differential diagnosis between benign and malignant breast mass.
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