目的：评估超声造影（CEUS）指导乳腺病变活检的有效性，这些病变在乳腺造影（CEM）或对比增强乳腺MRI（CE-MRI）上检测到，但在B超（B-US）上并不清楚。
方法：在本研究中，尽管在CEM(n=20)或CE-MRI(n=3)上检测到,但由于B-US显示不良,16例患者中的23个病灶被选择进行CEUS引导活检.B-US,彩色多普勒超声（CDUS），和CEUS用于可视化可疑病变，随后使用Sonazoid作为对比剂进行CEUS引导的核心针活检。根据病理学-放射学一致性和12个月的影像学随访评估活检的准确性。使用两位乳腺放射科医师商定的5点显着性量表评估病变可视化的显着性得分。
结果：在CEM/CE-MRI上发现的增强性病变的平均大小为1.6±1.3cm，表现为肿块增强（61％）或非肿块增强（39％）。病变在B-US上的平均显眼评分为2.30，2.78onCDUS,和4.61在CEUS上，96％的病变在CEUS上显示对比增强。与B-US和CDUS相比，CEUS引导活检显示96％和91％的病变可见性增加，分别。根据与组织学和12个月随访的一致性，CEUS引导活检的总体准确性为100％。
结论：CEUS增强了可疑CEM/CE-MRI病变的可见性，而在活检过程中，CEM/CE-MRI病变在B-US上几乎不可见。
OBJECTIVE: To assess the effectiveness of contrast-enhanced ultrasound (CEUS) in guiding biopsies of breast lesions that were detected on contrast-enhanced mammography (CEM) or contrast-enhanced breast MRI (CE-MRI) but were not clearly visible on B-mode ultrasound (B-US).
METHODS: In this study, 23 lesions in 16 patients were selected for CEUS-guided biopsy due to poor visualization on B-US despite being detected on CEM (n = 20) or CE-MRI (n = 3). B-US, color Doppler ultrasound (CDUS), and CEUS were used to visualize the suspicious lesions, followed by a CEUS-guided core needle biopsy using Sonazoid as the contrast agent. The accuracy of the biopsy was assessed based on pathology-radiology concordance and 12-month imaging follow-up. The conspicuity scores for lesion visualization were evaluated using a 5-point conspicuity scale agreed upon by two breast radiologists.
RESULTS: The enhancing lesions detected on CEM/CE-MRI had an average size of 1.6 ± 1.3 cm and appeared as mass-enhancing (61%) or non-mass-enhancing (39%). The lesions had mean conspicuity scores of 2.30 on B-US, 2.78 on CDUS, and 4.61 on CEUS, with 96% of the lesions showing contrast enhancement on CEUS. CEUS-guided biopsy showed increased visibility in 96% and 91% of the lesions compared to B-US and CDUS, respectively. The overall accuracy of CEUS-guided biopsy was 100% based on concordance with histology and 12-month follow-up.
CONCLUSIONS: CEUS enhances the visibility of suspicious CEM/CE-MRI lesions that are poorly visible on B-US during biopsy procedures.
