Objective:

To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) with Breast Imaging Reporting and Date System (BI-RADS) classification in the diagnosis of benign and malignant breast non-mass-like lesion (NML).

Methods:

A total of 182 cas

es of NML diagnosed by ultrasound were included. After classified by BI-RADS

all the lesions underwent CEUS. Multivariate logistic regression models were established for CEUS to diagnose breast malignancy. And then classified by BI-RADS according to the characteristics of CEUS thus compared with conventional ultrasound BI-RADS. The diagnostic performance of BI-RADS were compared between conventional ultrasound and CEUS.

Results:

The CEUS features of benign and malignant NML were significantly different in terms of enhancement intensity

lesions sizes after enhancement

enhancement time

peripheral radial enhancement

and visualization of penetrating vessel (

P

＜0.05). The BI-RADS classification between conventional ultrasound and CEUS were different significantly (

P

＜0.05). The sensitivity

specificity

accuracy

positive predictive value (PPV)

and negative predictive value (NPV) of the conventional ultrasound BI-RADS in diagnosis of malignant lesions were 75.28%

56.98%

65.93%

62.62% and 70.67%

respectively (area under curve=0.661; 95% CI: 0.582-0.741). The sensitivity

specificity

accuracy

PPV

and NPV of CEUS BI-RADS in diagnosis of malignant lesions were 93.26%

74.19%

83.52%

76.15% and 92.00%

respectively (area under curve=0.837; 95% CI: 0.775-0.899).

Conclusion:

CEUS with BI-RADS classification can remarkably improve the diagnosis efficacy of benign and malignant breast NML

reduce biopsy and contribute to clinical management.