The contrast enhanced ultrasound qualitative diagnosis of benign and malignant in BI-RADS 4 breast nodules with different sizes / 中华超声影像学杂志

ABSTRACT

Objective:To evaluate the qualitative diagnosis of contrast enhanced ultrasound (CEUS) in different sizes′ benign and malignant breast nodules (BNs) of BI-RADS 4.Methods:A total of 506 BNs in 467 patients from Shanghai General Hospital between October 2017 and May 2019 classified as BI-RADS 4 were divided into large size group (>20 mm, n=198) and small size group (≤20 mm, n=308) according to their largest diameter lines. The CEUS characteristics of benign and malignant BNs in two groups were analyzed by Chi-square test. The CEUS characteristics of BNs were assigned scores for diagnosis of benign and malignant BNs with different sizes, the diagnostic efficacy of these scores was evaluated by ROC curve. Results:There were statistic differences in the degree, size change of the enhanced lesions, enhancement time of lesions compared with surrounding tissues, radial enhancement or not, homogeneity of enhancement, with or without penetrating of perfusion between benign and malignant BNs in both groups (all P<0.001). In small size group, with the critical value of 2.5 points, area under curve(AUC) of ROC curve was 0.793, and the sensitivity, specificity, accuracy of CEUS was 82.67%, 60.22% and 69.48%, respectively. In large size group, with the critical value of 3.5 points, AUC of ROC curve was 0.901, and the sensitivity, specificity, accuracy of CEUS was 85.42%, 80.00% and 82.65%, respectively. Conclusions:CEUS has great significance in qualitative diagnosis of benign and malignant in BI-RADS 4 BNs with different sizes. The biopsy could be avoided in BNs greater than 20 mm, while biopsy is still needed in BNs less than or equal to 20 mm.