Values Of Contrast-Enhanced Ultrasound Combined With Bi-Rads In Differentiating Benign And Malignant Breast Lesions

Background: Conventional ultrasound with breast imaging reporting and data system (BI-RADS) is often used for diagnosing the breast lesions, but has not considered the blood supply of the tumor. This study aimed to investigate the values of contrast enhanced ultrasound (CEUS) combined with BI-RADS in differentiating benign and malignant breast lesions. Methods: One hundred and forty-nine patients with 149 breast lesions were enrolled. The conventional ultrasound and CEUS examinations were performed on the breast lesions. The images of conventional ultrasound were analyzed and categorized based on BI-RADS. After CEUS, the BI-RADS categorizing of CEUS was corrected. The sensitivity, specificity and accuracy of each method were calculated, and the receiver operating characteristic (ROC) curve was drawn to determine the diagnostic efficiency. Results: In conventional ultrasound, there were 20, 30, 89 and 10 cases with BI-RADS category 2, 3, 4 and 5, respectively. All ultrasound image features had significant difference between benign and malignant groups, including lesion shape, direction, margin, echo type, posterior echo, calcification and Adler grade of blood flow (P < 0.001). In CEUS, there were 45, 27, 44 and 33 cases with BI-RADS category 2, 3, 4 and 5, respectively. All the CEUS image features had significant difference between benign and malignant groups, including enhancement intensity, enhancement range, margin after enhancement, contrast agent distribution and tumor nourishing vessel distribution (P < 0.001). There was no significant difference of sensitivity between conventional ultrasound and CEUS (P > 0.05), but the specificity and accuracy of CEUS were significantly higher than those of conventional ultrasound, respectively (P < 0.01). The AUC of CEUS was significantly higher than that of conventional ultrasound (P < 0.001). Conclusion: CEUS combined with BI-RADS can significantly improve the differentiation ability of breast lesions, and it is worthy of application in clinic.