Application of Contrast‐Enhanced Ultrasound in the Diagnosis of Ductal Carcinoma In Situ: Analysis of 127 Cases

Li, Weiwei; Zhou, Qinghua; Xia, Shujun; Wu, Ying; Fei, Xiaochun; Wang, Yi; Tao, Lingling; Fan, Jinfang; Zhou, Wei

doi:10.1002/jum.15069

Cited by 13 publications

(8 citation statements)

References 35 publications

(69 reference statements)

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“…Typical malignant lesions often have a rich blood flow, unstable blood vessels, varying diameters, and incomplete vascular walls, leading to the rapid perfusion of tumors. The enlargement of the enhancement area may reflect the true density and distribution of microvessels in malignant lesions (32). The incidence of high enhancement in malignant lesions (94.6%) is higher than that in benign lesions (47.3%), which may be due to the increase in the number of vessels in tumor tissues caused by the stimulation of tumor angiogenesis factors (32).…”

Section: Discussionmentioning

confidence: 99%

“…The enlargement of the enhancement area may reflect the true density and distribution of microvessels in malignant lesions (32). The incidence of high enhancement in malignant lesions (94.6%) is higher than that in benign lesions (47.3%), which may be due to the increase in the number of vessels in tumor tissues caused by the stimulation of tumor angiogenesis factors (32). Also, owing to the dense distribution of blood vessels and the lack of a thin new vascular wall in the muscular layer, the formed arteriovenous fistula may lead to a greater internal blood flow increase (14).…”

Section: Discussionmentioning

confidence: 99%

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Determining whether the diagnostic value of B-ultrasound combined with contrast-enhanced ultrasound and shear wave elastography in breast mass-like and non-mass-like lesions differs: a diagnostic test

Li¹,

Niu²,

Wang³

et al. 2023

Gland Surg

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Background: Mass-like (ML) and non-mass-like (NML) are two manifestations of breast lesions on ultrasound. Contrast-enhanced ultrasound (CEUS) can make up for the limitation of B-ultrasound (US) in the observation of focal blood flow, and shear wave elastography (SWE) can supplement the hardness information of the lesion. The present study aimed to analyze the characteristic manifestations of US, CEUS, and SWE in NML and ML breast and evaluate whether the diagnostic performance of these three ultrasound techniques differs in terms of differentiating between benign and malignant breast lesions.Methods: From January to August 2021, 382 patients (417 breast lesions) underwent US, CEUS, and SWE examinations. Of these, 204 women (218 breast lesions) were included in our study due to subsequent biopsy or surgery with pathological findings. The patients were divided into ML and NML groups according to the ultrasound characteristics, and the differences in multimodal ultrasound performance between benign and malignant NML and benign and malignant ML breast lesions were compared. The diagnostic performance of US, US + CEUS, US + SWE, US + CEUS + SWE for ML, NML and all breast lesions was evaluated by analyzing sensitivity, specificity and area under receiver operating characteristic (ROC) curve (AUC).Results: Pathologically, the 218 lesions included 96 malignant and 122 benign breast lesions. The sensitivity and specificity of US + CEUS + SWE in all lesion groups, ML group and NML group were 92.7% and 90.2%, 95.9% and 90.3%, 91.3% and 79.3%, respectively. In all breast group, AUCs of US + CEUS, US + SWE, US + CEUS + SWE were statistically different from AUC of US (P=0.0010, 0.0001, 0.0001). In the ML group, the AUC of US + CEUS, US + SWE, US + CEUS + SWE were statistically different from that of US (P=0.0120, 0.0008, 0.0002). In the NML group, there was a statistical difference between US + SWE and US AUC (P=0.0149).Conclusions: US, CEUS, and SWE have an important diagnostic value for benign and malignant ML and NML breast lesions. Multimodal ultrasound combined with US, CEUS, and SWE can improve the diagnostic efficacy in distinguishing between benign and malignant ML and NML lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Determining whether the diagnostic value of B-ultrasound combined with contrast-enhanced ultrasound and shear wave elastography in breast mass-like and non-mass-like lesions differs: a diagnostic test

Li¹,

Niu²,

Wang³

et al. 2023

Gland Surg

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“…The American Institute of Ultrasound Medicine listed the following indications for hemodialysis access ultrasound: (I) inadequate hemodialysis blood flow 500–600 mL/min or decrease 25% interval of blood flow; (II) ipsilateral upper extremity edema or pain after access or during hemodialysis; (III) delayed maturation >6 weeks of AVF; (IV) suspected pseudoaneurysm, stenosis, soft tissue infection or adjacent fluid collection; (V) decreased or absent thrill or abnormal bruit; (VI) follow-up after an intervention; (VII) signs or symptoms of digital ischemia, (VIII) access collapse; (IX) prolonged bleeding >20 min from access site; (X) unexplained decrease in the delivered dose of hemodialysis; (XI) repeated difficult cannulation; (XII) thrombus aspiration; (XIII) elevated venous pressure greater than 200 mmHg on a 300 mL/min pump; (XIV) elevated recirculation time greater than 15% ( 15 ).…”

Section: Surveillancementioning

confidence: 99%

The role of hemodialysis access duplex ultrasound for evaluation of patency and access surveillance

Saati¹,

Puffenberger²,

Kirksey³

et al. 2023

Cardiovasc Diagn Ther

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The rise in prevalence of end stage renal disease (ESRD) and the impact on health care resulted in increasing focus on delivery of vascular access. Hemodialysis vascular access is the most common renal replacement therapy method. The vascular access types include arteriovenous fistula, arteriovenous graft, and tunneled central venous catheters. Vascular access function remains an important outcome measure with significant impact on morbidity and health care cost. The survival and quality of life of patients on hemodialysis is dependent on the adequacy of dialysis through proper vascular access. Early detection of failure to mature vascular access, stenosis, thrombosis, and aneurysm or pseudoaneurysm formation remains crucial. Ultrasound can help identify complications, even though ultrasound evaluation of the arteriovenous access is less well defined. Some published vascular access guidelines support ultrasound for detecting stenosis. The evolution of ultrasound has improved throughout the years, both multi parametric top-line systems and hand-held systems. Ultrasound evaluation is inexpensive, rapid, noninvasive, and repeatable, it is a powerful tool used for early diagnosis. The ultrasound image quality still depends on the skill of the operator. Careful attention to technical details is needed and avoidance of several diagnostic pitfalls is necessary. This review is focused on the role of ultrasound for hemodialysis access surveillance, evaluation of maturation, detection of access complications, and aid with cannulation.

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“…In the literature, the use of contrast-enhanced ultrasonography to differentiate fibroadenomas from ductal carcinoma in situ (DCIS) has been shown to be helpful. In contrast-enhanced ultrasonography examinations utilizing microbubble agents, DCIS is more likely than fibroadenoma to exhibit an earlier wash-in time, hyperintense enhancement, blood perfusion defects, an enlarged enhancement scope and penetrating vessels[ 19 ]. In addition, there are studies reporting that the use of digital breast tomosynthesis (DBT) in patients with dense breast tissue will increase sensitivity and specificity in the diagnosis of malignancy, as well as in the diagnosis and follow-up of benign lesions such as fibroadenoma.…”

Section: To the Editormentioning

confidence: 99%

Imaging of fibroadenoma: Be careful with imaging follow-up

Ece¹,

Aydın²

2022

WJCC

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The present letter to the editor is related to the study titled, “Preoperational diagnosis and management of breast ductal carcinoma in situ arising within fibroadenoma: Two case reports.” Fibroadenoma is the most common benign mass lesion in young females. Based on this study showing that malignancy can develop on fibroadenomas, we want to emphasize that careful sonographic follow-up of fibroadenomas should be done and that each lesion should be followed carefully and separately in cases with multiple fibroadenomas. Additionally, we want to emphasize the critical role of sonographic examination in diagnosing fibroadenoma, the importance of correctly defining benign and malignant sonographic findings, and which lesions should be followed up sonographically and which lesions should be evaluated histopathologically.

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Application of Contrast‐Enhanced Ultrasound in the Diagnosis of Ductal Carcinoma In Situ: Analysis of 127 Cases

Cited by 13 publications

References 35 publications

Determining whether the diagnostic value of B-ultrasound combined with contrast-enhanced ultrasound and shear wave elastography in breast mass-like and non-mass-like lesions differs: a diagnostic test

Determining whether the diagnostic value of B-ultrasound combined with contrast-enhanced ultrasound and shear wave elastography in breast mass-like and non-mass-like lesions differs: a diagnostic test

The role of hemodialysis access duplex ultrasound for evaluation of patency and access surveillance

Imaging of fibroadenoma: Be careful with imaging follow-up

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