Department of Radiology, Az Ospedaliero-universitaria Policlinico, via del pozzo 71, 41100 Modena, Italy.
Eur Radiol. 2010 Jun;20(6):1384-95. doi: 10.1007/s00330-009-1690-1. Epub 2009 Dec 22.
To evaluate the reliability of contrast-enhanced ultrasound quantitative analysis (CE-US) in characterizing breast lesions, in comparison with MRI.
Thirty-nine patients with breast lesions BI-RADS 3-5 at US or mammography underwent CE-US and MRI. All lesions underwent histological and quantitative enhancement evaluation with both imaging methods. B-mode US, colour/power Doppler US and CE-US were used; an amplitude and phase modulation technique (CPS) read the signals produced by microbubbles and dedicated software produced the following parameters on time/intensity (T/I) curves: peak %, time to peak (TTP), mean transit time (MTT), regional blood volume (RBV) and regional blood flow (RBF). Student's t test was used to calculate the diagnostic accuracy of CE-US parameters compared with histological results. MRI (1.5 T) was performed before and after bolus gadolinium enhancement. Time/intensity curves were generated for all nodules and Fischer's multimodal score was used to classify them.
Pathology showed 43 nodules (11 benign; 32 malignant). Peak and RBF were the most significant parameters in differential diagnosis, with p values of 0.02 and 0.004, respectively. Positive predictive value (PPV) of CE-US evaluation was 91%, negative predictive value (NPV) was 73% with a high concordance index (k = 0.59) with MRI.
CE-US quantitative analysis offers an objective and reproducible assessment of lesion vascularisation, with good correlation with the results of MRI.
评估对比增强超声定量分析（CE-US）在描述乳腺病变方面的可靠性，与 MRI 进行比较。
39 例经 US 或乳腺 X 线摄影 BI-RADS 3-5 级的乳腺病变患者接受了 CE-US 和 MRI 检查。所有病变均通过两种成像方法进行了组织学和定量增强评估。使用了 B 型超声、彩色/能量多普勒超声和 CE-US；幅度和相位调制技术（CPS）读取微泡产生的信号，专用软件在时间/强度（T/I）曲线上生成以下参数：峰值%、达峰时间（TTP）、平均渡越时间（MTT）、局部血容量（RBV）和局部血流量（RBF）。使用学生 t 检验计算 CE-US 参数与组织学结果相比的诊断准确性。1.5 T 磁共振成像（MRI）在造影剂增强前后进行。为所有结节生成 T/I 曲线，并使用 Fischer 多模态评分对其进行分类。
病理显示 43 个结节（11 个良性；32 个恶性）。在鉴别诊断中，峰值和 RBF 是最显著的参数，p 值分别为 0.02 和 0.004。CE-US 评估的阳性预测值（PPV）为 91%，阴性预测值（NPV）为 73%，与 MRI 的一致性指数（k=0.59）较高。
CE-US 定量分析为病变血管化提供了客观和可重复的评估，与 MRI 结果具有良好的相关性。
