Rubin E, Miller V E, Berland L L, Han S Y, Koehler R E, Stanley R J
AJR Am J Roentgenol. 1985 Mar;144(3):623-7. doi: 10.2214/ajr.144.3.623.
The results of real-time hand-held sonographic breast examinations on 86 patients are presented. The technique is described in detail. Sonography was found to be a useful adjunct to the x-ray mammogram in three groups of patients: (1) patients with dense breasts and localized symptomatology or a suspicious area on x-ray mammogram; (2) patients with nonpalpable abnormalities discovered on x-ray mammogram; and (3) patients with palpable masses considered indeterminate on x-ray mammogram. The examination was also found useful for guiding needle aspiration biopsies, in patients with persistent nipple discharge, and in those with breast prostheses. Advantages of the hand-held real-time technique include supine positioning, the ability to flexibly orient the probe, improved resolution due to higher frequency transducers and the lack of compounding, and the ability to vary the amount of compression to assess tissue compliance and fixation. The disadvantage of decreased resolution in the near field can be overcome by attaching a detachable water-path step-off device to the transducer. Geometric distortion from the pressure of the transducer was not believed to be a problem. Hand-held sonographic technique is useful when attention can be directed to a specific area of the breast. The additional information provided results in fewer equivocal interpretations of the x-ray mammogram; however, it should not be used as a substitute for routine mammography.
本文展示了对86例患者进行实时手持式超声乳腺检查的结果。详细描述了该技术。超声检查在三组患者中被发现是X线乳房造影的有用辅助手段：（1）乳房致密且有局部症状或X线乳房造影上有可疑区域的患者；（2）X线乳房造影上发现不可触及异常的患者；（3）X线乳房造影上被认为不确定的可触及肿块患者。该检查在引导针吸活检、乳头持续溢液患者以及乳房假体患者中也被发现有用。手持式实时技术的优点包括仰卧位、探头可灵活定向、由于高频换能器和无复合作用而提高的分辨率，以及能够改变压迫量以评估组织顺应性和固定情况。近场分辨率降低的缺点可通过在换能器上连接可拆卸的水路径阶梯装置来克服。认为换能器压力引起的几何畸变不是问题。当注意力可指向乳房的特定区域时，手持式超声技术是有用的。所提供的额外信息减少了X线乳房造影的模糊解读；然而，它不应被用作常规乳房造影的替代方法。
