Richter K, Heywang-Köbrunner S H
Strahlenabteilung, Auguste-Viktoria-Krankenhaus, Berlin, Germany.
AJR Am J Roentgenol. 1995 Oct;165(4):825-31. doi: 10.2214/ajr.165.4.7676975.
The purpose of this study was to test the value of indirect measurements of ultrasound velocity in the sonographic differentiation of benign from malignant breast lesions.
One hundred six mammographically examined preoperative patients with 54 benign and 70 malignant histopathologically proven lesions were examined as follows. The compressed breast was completely penetrated by an ultrasound beam from a 7.5-MHz linear transducer. A stainless steel plate underneath the breast appeared on sonograms of normal breast tissue as a hyperechoic line. Some lesions caused changes in the attenuation and velocity of the ultrasound beam, which in turn caused the hyperechoic line representing the steel plate below those lesions on sonograms to appear elevated and changed in echogenicity. By measuring elevation, if any, and the corresponding length of lesions on the sonogram, we studied the results of this sonographic examination and compared them with mammographic findings.
Sixty of the 70 cancers caused the hyperechoic line representing the steel plate on sonograms to appear elevated and changed in echogenicity at points below those lesions. Twenty-five of the 54 benign lesions also showed this effect, but the amount of elevation seen on sonograms was smaller with 14 of these 25 lesions than with 57 of the 60 malignant lesions. The new method complements mammographic findings by true definition of mammographically false-negative cancers and false-positive benign lesions. Accuracy was improved by use of both mammography and sonography in comparison with that obtained with mammography alone (85% versus 73%).
Indirect measurement of relative ultrasound velocity can help differentiate benign from malignant breast lesions. The systematic use of mammography and this new sonographic method might improve the detection of cancers and help avoid biopsies of benign lesions.
本研究旨在检验超声速度间接测量值在乳腺良恶性病变超声鉴别诊断中的价值。
对106例术前行乳腺钼靶检查的患者进行了如下检查，这些患者经病理证实有54个良性病变和70个恶性病变。使用7.5兆赫线性换能器发出的超声束完全穿透受压迫的乳房。乳房下方的不锈钢板在正常乳腺组织的超声图像上表现为高回声线。一些病变会引起超声束衰减和速度的变化，进而导致代表病变下方钢板的高回声线在超声图像上出现抬高且回声性改变。通过测量超声图像上病变的抬高情况（如有）及相应长度，我们研究了此项超声检查的结果，并将其与乳腺钼靶检查结果进行比较。
70例癌症中有60例导致超声图像上代表钢板的高回声线在病变下方的点处出现抬高且回声性改变。54例良性病变中有25例也有此表现，但这25例病变中14例在超声图像上的抬高程度小于60例恶性病变中的57例。这种新方法通过明确乳腺钼靶检查中的假阴性癌症和假阳性良性病变，补充了乳腺钼靶检查结果。与单纯使用乳腺钼靶检查相比，联合使用乳腺钼靶检查和超声检查提高了准确性（85%对73%）。
超声相对速度的间接测量有助于鉴别乳腺良恶性病变。系统使用乳腺钼靶检查和这种新的超声检查方法可能会提高癌症的检出率，并有助于避免对良性病变进行活检。
