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Multimodality ultrasonic observation in the marginal zone of breast lesions with BI-RADS grade 4 or above |
1.Department of Ultrasonography, the Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China;
2.Department of Radiochemotherapy, the Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China) |
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Abstract Objective: To evaluate their application value in observing the marginal zone of breast lesions with BI-RADS grade 4 or above by 2D-CEUS, 3D-CPA and 3D-CEUS. Method: One hundred and eighty-two pathologically proved benign and malignant breast lesions with BI-RADS grade 4 or above received examinations in the order of 2D-CEUS, 3D-CPA and 3D-CEUS. The marginal zone, the central region and the adjacent gland tissue for all lesions were analyzed and compared by time-intensity curve using QLab software. Three dimensional reconstruction of power Doppler and contrast-enhanced images were performed in the marginal zone and 4 levels were divided according to the blood supply. The abilities to display the vascular structure of breast lesions by 3D-CEUS and 3D-CPA were compared. Results: For cancers, the marginal zone had different ultrasonic perfusion parameters from the central region and adjacent normal gland tissue(F=7.782 7, P<0.000 1). Compared with the adjacent tissue, the marginal and central regions showed obvious enhancement with quick access and slow retreat. Compared with the central region, the marginal zone showed medium enhancement with quick access and slow retreat(P<0.05). For benign lesions, the marginal and central zones showed obvious enhancement with quick access and quick retreat in comparison to adjacent normal tissue. Compared with the central region, the marginal zone showed medium enhancement with quick access and quick retreat(P<0.05). 3D-CPA and 3D-CEUS in the periphery of breast cancers were characterized by more blood supply of grade Ⅲ or Ⅳ compared to benign breast lesions(P<0.05). Blood supply levels were higher by 3D-CEUS than by 3D-CPA(P<0.05). Conclusion: The marginal zone contributed more to the malignant imaging features than the central region for contrast-enhanced ultrasound in breast cancer. 3D-CEUS was superior to 3D-CPA in manifesting the blood vascular structure in the marginal zone of breast lesions of BI-RADS grade 4 or above. 2D-CEUS combined with 3D-CPA and 3D-CEUS can better display blood perfusion in the marginal zone of breast cancers.
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Received: 06 February 2015
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