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

Objectives To explore the characteristics of breast ductal carcinoma in situ (DCIS) on real‐time grayscale contrast‐enhanced ultrasound (CEUS) imaging and the diagnostic value of CEUS in DCIS. Methods A total of 127 histopathologically confirmed DCIS lesions and 124 fibroadenomas (FAs; controls) were subjected to conventional ultrasound and CEUS. Next, the CEUS findings of DCIS and FA lesions, including morphologic features and quantitative parameters, were analyzed. Results Binary logistic regression was used to identify the independent risk factors from DCIS and FA lesions detected by CEUS. Contrast‐enhanced ultrasound revealed significant differences between DCIS and FA. The wash‐in time, enhancement mode, enhancement intensity, blood perfusion defects, peripheral high enhancement, enhancement scope, intratumoral vessels and their courses and dilatation degree, and penetrating vessels on CEUS were identified as features correlated with DCIS ( P < .05). Moreover, a multivariate logistic regression analysis was developed, and the area under receiver operating characteristic curve of each index was generated, including the wash‐in time, enhancement intensity, blood perfusion defects, enhancement scope, penetrating vessels, arrival time, and peak intensity ( P < .05; area under the curve, >0.6). Conclusions The contrast‐enhancement patterns and DCIS parameters appeared different from FA lesions, thus suggesting that CEUS can be very useful in distinguishing DCIS from FA lesions.