Mesurolle Benoît, Helou Tarek, El-Khoury Mona, Edwardes Michael, Sutton Elizabeth J, Kao Ellen
Department of Radiology, McGill University Health Center, Montreal General Hospital, Montreal, QC, Canada.
J Ultrasound Med. 2007 Aug;26(8):1041-51. doi: 10.7863/jum.2007.26.8.1041.
The purpose of this study was to evaluate different sonographic settings (tissue harmonic, frequency compounding, and conventional imaging) and to determine which setting optimizes breast lesion detection and lesion characterization.
Four hundred thirteen consecutive breast lesions (249 benign and 164 malignant) were evaluated by sonography using 4 different modes (conventional imaging at 14 MHz, tissue harmonic imaging at 14 MHz [THI], and frequency compound imaging at 10 MHz [CI10] and 14 MHz [CI14]). The images were reviewed by consensus by 2 breast radiologists. For each image, the lesion was graded for conspicuity, mass margin assessment, echo texture assessment, overall image quality, and posterior acoustic features.
For lesion conspicuity, THI and CI14 were better than conventional imaging (P < .01) and CI10 (P < .01) particularly against a fatty background (P < .01 for THI versus conventional for a fatty background versus P = .13 for a dense background). Frequency compound imaging at 10 MHz performed the best in echo texture assessment (P < .01), as well as overall image quality (P < .01). For margin assessment, CI10 performed better for deep and large (> or =1.5-cm) lesions, whereas CI14 performed better for small (<1.5-cm) and superficial lesions. Finally, THI and CI14 increased posterior shadowing (P < .01) and posterior enhancement (P < .01).
The standard breast examination incorporates 2 distinct processes, lesion detection and lesion characterization. With respect to detection, THI is useful, especially in fatty breasts. With respect to characterization, compound imaging improves lesion echo texture assessment. No single setting in isolation can provide the necessary optimized information for both of these tasks. As such, a combination approach is best.
本研究旨在评估不同的超声检查设置（组织谐波成像、频率复合成像和传统成像），并确定哪种设置能优化乳腺病变的检测及病变特征描述。
连续纳入413个乳腺病变（249个良性病变和164个恶性病变），采用4种不同模式进行超声检查（14MHz传统成像、14MHz组织谐波成像[THI]、10MHz频率复合成像[CI10]和14MHz频率复合成像[CI14]）。由2名乳腺放射科医生共同对图像进行评估。对每张图像的病变进行清晰度、肿块边缘评估、回声质地评估、整体图像质量及后方声学特征的分级。
对于病变清晰度，THI和CI14优于传统成像（P < 0.01）和CI10（P < 0.01），尤其是在脂肪背景下（脂肪背景下THI与传统成像相比P < 0.01，致密背景下P = 0.13）。10MHz频率复合成像在回声质地评估（P < 0.01）以及整体图像质量方面（P < 0.01）表现最佳。对于边缘评估，CI10对深部和较大（≥1.5cm）病变表现更好，而CI14对较小（<1.5cm）和浅表病变表现更好。最后，THI和CI14增加了后方阴影（P < 0.01）和后方增强（P < 0.01）。
标准的乳腺检查包含两个不同的过程，即病变检测和病变特征描述。在检测方面，THI很有用，尤其是在脂肪型乳腺中。在特征描述方面，复合成像改善了病变回声质地评估。没有单一的设置能为这两项任务提供必要的优化信息。因此，联合使用多种方法是最佳选择。
