An Yeong Yi, Kim Sung Hun, Kang Bong Joo
Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Eur J Radiol. 2015 Jul;84(7):1232-5. doi: 10.1016/j.ejrad.2015.04.007. Epub 2015 Apr 20.
To prospectively evaluate the image quality of automated whole breast ultrasonography (AWUS) in the characterization of breast lesions compared with handheld breast ultrasonography (HHUS).
This prospective study included a total of 411 lesions in 209 women. All patients underwent both HHUS and AWUS prior to biopsy. An evaluation of identical image pairs of 411 lesions obtained from both modalities was performed, and the image quality of AWUS was compared with that of HHUS as a reference standard. The overall image quality was evaluated for lesion coverage, lesion conspicuity, and artifact effect using a graded score. Additionally, the factors that correlated with differences in image quality between the two modalities were analyzed.
In 97.1%, the image quality of AWUS was identical or superior to that of HHUS, whereas AWUS was inferior in 2.9%. In only 0.5%, the poor quality of AWUS images caused by incomplete lesion coverage and shadowing due to a contact artifact inhibited precise interpretations. The two main causes resulting in degraded AWUS image quality were blurring of the margin (83.3%) and acoustic shadowing by Cooper's ligament or improper compression pressure of the transducer (66.7%). Among various factors, peripheral location from the nipple (p=0.01), lesion size (p=0.02), shape descriptor (p=0.02), and final American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) category (p=0.001) were correlated with differences in image quality between AWUS and HHUS.
Although the image quality of AWUS was comparable to that of HHUS for lesion interpretation, HHUS was clearly superior to AWUS for analyzing lesions with a peripheral location, an irregular shape, a non-circumscribed margin and BI-RADS category 4 or 5.
前瞻性评估自动全乳腺超声检查（AWUS）与手持乳腺超声检查（HHUS）在乳腺病变特征描述方面的图像质量。
这项前瞻性研究共纳入209名女性的411个病变。所有患者在活检前均接受了HHUS和AWUS检查。对两种检查方式获取的411个病变的相同图像对进行评估，并将AWUS的图像质量与作为参考标准的HHUS的图像质量进行比较。使用分级评分对病变覆盖范围、病变清晰度和伪像效应的整体图像质量进行评估。此外，分析了与两种检查方式图像质量差异相关的因素。
97.1%的情况下，AWUS的图像质量与HHUS相同或优于HHUS，而AWUS较差的情况占2.9%。仅0.5%的情况下，由于病变覆盖不完整和接触伪像导致的阴影使AWUS图像质量较差，从而妨碍了精确解读。导致AWUS图像质量下降的两个主要原因是边缘模糊（83.3%）以及库珀韧带造成的声影或换能器压迫压力不当（66.7%）。在各种因素中，距乳头的外周位置（p = 0.01）、病变大小（p = 0.02）、形状描述符（p = 0.02）以及最终的美国放射学会乳腺影像报告和数据系统（BI-RADS）分类（p = 0.001）与AWUS和HHUS之间的图像质量差异相关。
虽然在病变解读方面AWUS的图像质量与HHUS相当，但对于分析外周位置、不规则形状、边界不清以及BI-RADS分类为4或5的病变，HHUS明显优于AWUS。
