Reinikainen H, Rissanen T, Päivänsalo M, Pääkkö E, Jauhiainen J, Suramo I
Department of Diagnostic Radiology, Oulu University Central Hospital, Finland.
Acta Radiol. 2001 Jan;42(1):106-13.
To investigate the role of B-mode and unenhanced and enhanced power Doppler ultrasonography (US) in differentiating solid breast lesions, and to find out whether morphologically different tumors differ in terms of vascularity.
Sixty-five lesions, indeterminate or suggestive of malignancy after mammography were prospectively examined with B-mode and unenhanced and enhanced power Doppler US. The lesions were classified as benign, indeterminate or malignant at B-mode, and as benign or malignant at power Doppler US. The results were compared to the histologic diagnoses. Vascularity was analyzed also quantitatively to find out whether threshold values for differential diagnostics could be set.
The sensitivity, specificity, and overall accuracy of the morphologic evaluation were 100%, 10%, and 57%, respectively. Rounded lesions were more vascular than spiculated lesions, but vascular assessment was only helpful when it supported a benign morphology. In quantitative analysis, due to the overlap between the benign and malignant lesions, no threshold values could be set.
Morphologic criteria were useful in characterizing malignant lesions, but the large proportion of indeterminate findings decreased the specificity of US. Neither unenhanced, nor enhanced power Doppler US was able to improve diagnostic accuracy.
研究B超、未增强及增强功率多普勒超声检查在鉴别乳腺实性病变中的作用，并探究形态学不同的肿瘤在血管分布方面是否存在差异。
对65例经乳腺X线摄影检查后性质未明或疑似恶性的病变进行前瞻性研究，采用B超、未增强及增强功率多普勒超声检查。这些病变在B超下分为良性、性质未明或恶性，在功率多普勒超声下分为良性或恶性。将结果与组织学诊断结果进行比较。还对血管分布进行了定量分析，以确定是否可以设定鉴别诊断的阈值。
形态学评估的敏感性、特异性和总体准确率分别为100%、10%和57%。圆形病变的血管分布比毛刺状病变更多，但血管评估仅在支持良性形态时才有用。在定量分析中，由于良性和恶性病变之间存在重叠，无法设定阈值。
形态学标准有助于鉴别恶性病变，但大量性质未明的结果降低了超声检查的特异性。未增强及增强功率多普勒超声均无法提高诊断准确性。
