Objective To analyze the relationships between the contrast enhanced ultrasound（CEUS）features and vascular mimicry（VM）in breast cancer

and to explore its value in differential diagnosis.Methods A total of 152 breast cancer patients confirmed as invasive ductal carcinoma by pathology were enrolled.The conventional ultrasound and contrast enhanced ultrasound were performed before surgery. Pathological examinations were conducted with the specimens after surgery. The clinicopathologic parameters（age

tumor size

clinical stage

lymph node metastasis）and contrast enhanced ultrasound features（homogeneity

with or without perfusion defect

enhancement intensity

enhancement morphology

enhancement margin type

ect）were recorded.The differences of contrast enhanced ultrasound features of breast tumor in VM positive or negative statues were analyzed.The receiver operating characteristic（ROC）curve was drawn to analyze the diagnostic efficacy of various factors to identify VM positive.ResultsAmong 152 breast cancer patients

the VM positive rate was 26.3%.The tumors with diameter >2 cm

clinical stage of Ⅲ and Ⅳ

and axillary lymph node metastasis were associated with VM positive lesions（all P<0.05）. The contrast enhanced ultrasound features of tumors with irregular enhancement morphology of the lesions

irregular unclear margin

fast-in and fast-out

fast-in and slow-out pattern were associated with VM positive lesions（all P<0.05）. The enhancement irregular unclear margin had the highest value in clearly distinguishing VM-positive

the area under the curve（AUC）was 0.764

and the accuracy

sensitivity and specificity were 85.0%

66.7% and 90.3%

respectively.Conclusion Contrast enhanced ultrasound features have a certain correlation with VM positive statue. The features of tumors with irregular enhancement morphology

irregular unclear margin

fast-in and fast-out pattern can be a useful supplementary method for the diagnosis of VM positive breast cancer.