Saracco Ariel, Szabó Botond K, Aspelin Peter, Leifland Karin, Tánczos Ervin, Wilczek Brigitte, Axelsson Rimma
Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
Department of Radiology, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Acta Radiol. 2015 Jan;56(1):34-41. doi: 10.1177/0284185114520860. Epub 2014 Jan 20.
In the last few years new potential applications have been developed for contrast-enhanced ultrasound (CEUS) and the management of breast diseases, but there is still some debate concerning the optimal dose to evaluate breast lesions, especially as a diagnostic tool.
To compare different CEUS doses of injected contrast agent in order to establish an optimal dose for the diagnosis of invasive breast cancer.
In Group A we compared the bolus dose of 1.2 mL vs. 2.4 mL and in Group B we compared the bolus dose of 2.4 mL vs. 4.8 mL (26 and 25 invasive carcinomas, respectively). CEUS was performed in real-time contrast harmonic imaging (CHI) using a L9-3 MHz probe. All examinations were recorded in a contrast side/side imaging mode loop for 120 s. Wash-in and wash-out patterns of the contrast agent were analyzed with advanced US quantification software and kinetic curves were used for statistical analysis.
In Group B (2.4 mL vs. 4.8 mL), more and stronger correlation was found among kinetic parameters (area under the curve, P < 0.00001; lognormal model parameters, μ, P = 0.0007 and σ, P < 0.0001; mean transit time, P < 0.0001; model-based wash-out ratios, W21m, P = 0.0002; W50m, P = 0.0001; time-to-peak, P = 0.005) as compared to Group A (1.2 mL vs. 2.4 mL).
The optimal way to evaluate kinetic features of invasive breast tumors using real-time CEUS is with an injection of contrast agent of either 2.4 mL or 4.8 mL.
在过去几年中，超声造影（CEUS）在乳腺疾病的管理方面已开发出一些新的潜在应用，但关于评估乳腺病变的最佳剂量，尤其是作为一种诊断工具，仍存在一些争议。
比较不同剂量的超声造影剂，以确定诊断浸润性乳腺癌的最佳剂量。
A组比较了1.2毫升与2.4毫升的团注剂量，B组比较了2.4毫升与4.8毫升的团注剂量（分别为26例和25例浸润性癌）。使用L9 - 3MHz探头以实时对比谐波成像（CHI）模式进行CEUS检查。所有检查均以对比双侧成像模式循环记录120秒。使用先进的超声定量软件分析造影剂的流入和流出模式，并使用动力学曲线进行统计分析。
与A组（1.2毫升与2.4毫升）相比，B组（2.4毫升与4.8毫升）在动力学参数之间发现了更强的相关性（曲线下面积，P < 0.00001；对数正态模型参数，μ，P = 0.0007，σ，P < 0.0001；平均通过时间，P < 0.0001；基于模型的洗脱率，W21m，P = 0.0002；W50m，P = 0.0001；达峰时间，P = 0.005）。
使用实时CEUS评估浸润性乳腺肿瘤动力学特征的最佳方法是注射2.4毫升或4.8毫升的造影剂。
