ObjectiveTo determine the correlation of real-time contrast-enhanced ultrasonography (CEUS) patterns and quantitative parameters with microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression of breast tumors.Methods One hundred and five patients with 128 breast lesions(62 benign,66 malignant) underwent CEUS examination.CEUS patterns were analyzed and parameters were obtained by time-intensity curve analysis software.Immunohistochemical staining using anti-factor CD34 was performed to evaluated the MVD and VEGF expression was detected.Results All CEUS patternsweresignificantlyassociatedwithMVDandVEGFexpressionexceptboundary characteristics( P ＜ 0.05).The enhancement parameters showed that the time to peak was significantly faster in malignant tumors than that in benign lesions,and the peak intensity and area under the curve were significantly higher in malignant tumors than those in benign lesions( P ＜0.05).The time to peak,the peak intensity,area under the time-intensity curve were statistically correlated with MVD (P ＜0.05),the highest correlation was between the area and MVD( r =0.81,P ＜0.001).Only the area under the timeintensity curve was significantly associated with VEGF expression (P ＜ 0.05).Conclusions CEUS patterns and parameters of breast lesions are closely correlated with MVD,which can be used to evaluated the angiogenesis in breast tumors.