Contrast-enhanced breast ultrasonography: imaging features with histopathologic correlation.
OBJECTIVE
The purpose of this study was to identify histopathologic correlates for the varied appearances of breast masses on contrast-enhanced ultrasonography (CEUS).


METHODS
Contrast-enhanced ultrasonography was performed in 104 patients (age range, 19-86 years) after administration of a sulfur hexafluoride microbubble contrast agent, and enhancement patterns were classified as no enhancement, peripheral enhancement, homogeneous enhancement, regional enhancement, and heterogeneous enhancement. All patients' histologic slides were reviewed and correlated with CEUS findings.


RESULTS
In malignant masses, heterogeneous enhancement corresponded to tumor cell cords or clusters in a variable amount of desmoplastic stroma. Homogeneous enhancement corresponded to hypercellularity in the whole mass, or ductal carcinoma in situ (DCIS) was predominant. Regional enhancement corresponded to a DCIS component. Peripheral enhancement corresponded to a DCIS component, hypercellularity or adenosis at the periphery, and low-degree cellularity, degeneration, fibrosis, or necrosis in the center. No enhancement was present in 1 case of low-grade DCIS. In benign masses, heterogeneous enhancement corresponded to loose cell proliferation in a more sclerotic stroma. Homogeneous enhancement corresponded to diffuse hypercellularity, an inflammatory cell infiltrate, or intraductal papilloma. Regional enhancement corresponded to focal hypercellularity or intraductal papilloma within a dilated duct. No enhancement corresponded to desmoplastic stroma. Peripheral enhancement was shown in 1 case of granulomatous mastitis with an inflammatory infiltrate at the periphery and necrosis in the center.


CONCLUSIONS
Breast mass CEUS findings correlated with histologic features.
Liu
He
H
Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Jiang
Yu-Xin
YX
Liu
Ji-Bin
JB
Zhu
Qing-Li
QL
Sun
Qiang
Q
Chang
Xiao-Yan
XY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D045423:Microbubbles; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012984:Software; D013459:Sulfur Hexafluoride; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult
D003287:Contrast Media; D013459:Sulfur Hexafluoride