Wright I A, Pugh N D, Lyons K, Webster D J, Mansel R E
Dept of Medical Physics and Bioengineering, University Hospital of Wales, CF4 4XW Cardiff, Wales, UK.
Eur J Ultrasound. 1998 Aug;7(3):175-81. doi: 10.1016/s0929-8266(98)00040-8.
Tumour vascularity can be assessed in-vivo using Doppler ultrasound. The purpose of this study was to determine whether Power Doppler imaging (PDI) better differentiates benign from malignant breast masses than conventional colour doppler imaging (CDI) on the basis of assessment of tumour vascularity.
One-hundred women with solid breast lumps (51 malignant lesions, 49 benign lesions) were investigated using a Toshiba SSA-270A ultrasound machine with a 5.0 MHz (3.75 MHz Doppler reference frequency) or a 7. 5 MHz (5.0 MHz Doppler reference frequency) linear array probe. The vascularity within or at the periphery of the mass was subjectively assessed from the CDI and Power Doppler images by two independent observers. It was assumed that the absence of vascularity indicated benignity and the presence of flow malignancy.
CDI showed sensitivities of 62 and 42% and specificities of 62 and 62% using the 5 and 7.5 MHz probes respectively. PDI showed sensitivities of 76 and 51% and specificities of 56 and 48% using the 5 and 7.5 MHz probes respectively. A comparison of images of the 59 lesions investigated with both probes on both CDI and PDI concluded that the 5 MHz (3.75 MHz DRF) probe displayed equal vascularity to the 7.5 MHz (5.0 MHz DRF) probe in 76% of cases and greater vascularity in 24% of cases on CDI, and 68 and 31% of cases respectively on PDI.
Power Doppler imaging with a 5 MHz (3.75 MHz DRF) probe increases the sensitivity of Doppler ultrasound to malignant breast tumours but the sensitivity achieved is not high enough to propose it as a screening investigation.
可使用多普勒超声在体内评估肿瘤血管。本研究的目的是基于肿瘤血管评估，确定能量多普勒成像（PDI）在鉴别乳腺良恶性肿块方面是否优于传统彩色多普勒成像（CDI）。
使用配备5.0 MHz（3.75 MHz多普勒参考频率）或7.5 MHz（5.0 MHz多普勒参考频率）线性阵列探头的东芝SSA - 270A超声仪，对100例患有实性乳腺肿块的女性（51例恶性病变，49例良性病变）进行检查。两名独立观察者从CDI和能量多普勒图像主观评估肿块内部或周边的血管情况。假定无血管表示良性，有血流表示恶性。
使用5 MHz和7.5 MHz探头时，CDI的敏感性分别为62%和42%，特异性分别为62%和62%。使用5 MHz和7.5 MHz探头时，PDI的敏感性分别为76%和51%，特异性分别为56%和48%。对用两种探头在CDI和PDI上检查的59个病变的图像进行比较得出，在CDI上，5 MHz（3.75 MHz DRF）探头在76%的病例中显示与7.5 MHz（5.0 MHz DRF）探头血管情况相同，在24%的病例中显示血管情况更多；在PDI上，分别为68%和31%的病例。
使用5 MHz（3.75 MHz DRF）探头的能量多普勒成像提高了多普勒超声对乳腺恶性肿瘤的敏感性，但所达到的敏感性不足以将其作为筛查检查。
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