Neoplasma. 2018;65(1):124-131. doi: 10.4149/neo_2018_170116N43.
The aim of this prospective study was to identify characteristics of breast lesions on contrast enhanced ultrasound (CEUS) that can be a source of diagnostic ambiguity and cause under- or overestimation of examined breast lesions. 215 women (range 23-76 y., mean age 53.16 y) with 215 breast lesions were examined by B-mode ultrasound, followed by CEUS and core biopsy. CEUS parameters: degree of opacification, character of washout and preliminary CEUS result (suspicious, non-suspicious, uncertain) were subsequently correlated with histopathological outcomes. Observed qualitative variables, CEUS results and their analysis with respect to histological type were evaluated using Pearson χ2 square test, p<0.05 was statistically significant. Differences in mean lesion size, mean age of patients, mean size between groups (malignant/benign) with respect to CEUS result were evaluated by t-test. 215 tumors, 116 (53.93%) benign and 99 (46.05%) malignant lesions. 17 (14.66%) benign and 15 (15.15%) malignant lesions expressed atypical washout, 5 (4.31%) benign lesions had early washout and 38 (38.38%) had continuous washout (p<0.0001). 56 (48.28%) benign and 55 (55.56%) malignant lesions had middle degree of opacification, 19 (16.38%) benign had high and 5 (5.05%) malignant lesions low degree of opacification (p<0.0001). Finally, 38 (32.72%) benign and 20 (20.20%) malignant were marked CEUS uncertain. As risk lesions are considered fibroadenomas, fibrocystic lesions, papillomas and low grade DCIS or invasive breast tumors, especially lesions smaller than 10 mm.Identification of CEUS pitfalls with respect to problematic histopathologic entities can reduce the risk of misdiagnosis and improve further management of breast lesions.
本前瞻性研究旨在确定增强超声（CEUS）中乳腺病变的特征，这些特征可能导致诊断模棱两可，并导致对检查的乳腺病变的低估或高估。对 215 名（年龄 23-76 岁，平均年龄 53.16 岁）女性的 215 个乳腺病变进行了 B 型超声检查，随后进行了 CEUS 和核心活检。CEUS 参数：混浊程度、洗脱特征和初步 CEUS 结果（可疑、非可疑、不确定）随后与组织病理学结果相关。使用 Pearson χ2 平方检验评估观察到的定性变量、CEUS 结果及其与组织学类型的分析，p<0.05 为统计学显著差异。根据 CEUS 结果评估平均病变大小、患者平均年龄、组间（良性/恶性）平均大小的差异使用 t 检验。215 个肿瘤，116 个（53.93%）良性和 99 个（46.05%）恶性病变。17 个（14.66%）良性和 15 个（15.15%）恶性病变表达非典型洗脱，5 个（4.31%）良性病变出现早期洗脱，38 个（38.38%）出现持续洗脱（p<0.0001）。56 个（48.28%）良性和 55 个（55.56%）恶性病变有中度混浊，19 个（16.38%）良性有高度混浊，5 个（5.05%）恶性病变有低度混浊（p<0.0001）。最后，38 个（32.72%）良性和 20 个（20.20%）恶性被标记为 CEUS 不确定。作为风险病变，考虑到纤维腺瘤、纤维囊性病变、乳头状瘤和低级别导管原位癌或浸润性乳腺癌，特别是小于 10mm 的病变。确定与有问题的组织病理学实体相关的 CEUS 缺陷可以降低误诊风险，并改善对乳腺病变的进一步管理。
