Carson P L, Fowlkes J B, Roubidoux M A, Moskalik A P, Govil A, Normolle D, LeCarpentier G, Nattakom S, Helvie M, Rubin J M
Department of Radiology, University of Michigan Medical Center, Ann Arbor 48109-0553, USA.
Ultrasound Med Biol. 1998 Sep;24(7):945-52. doi: 10.1016/s0301-5629(98)00055-6.
In this article, new measures obtained from color Doppler images are introduced and a pilot study is described, in which these and previously published indices are evaluated for use in future work. Twenty women with breast masses observed on mammography and going to surgical biopsy were studied. Of the masses, 11 proved to be benign and 9 were malignant. Both 3-D mean frequency shift (f-CDI) and power mode Doppler (p-CDI) imaging were performed. To identify the mass and other regions of interest, vessels were displayed as rotatable 3-D color volumes, superimposed on selectable grey-scale/color flow slices. Doppler signals were recorded in each of 6 ellipsoidal regions of interest in and around the mass and 2 in normal tissues. Seven measures were computed in each region, three from power mode, two from mean frequency and two from combinations of both. Radiologists rated the grey-scale appearances of the masses on a scale of 1 to 5 (5=most suspicious) for each of 6 conventional grey-scale criteria. Of the individual vascularity measures in individual ROIs, the log speed-weighted pixel density and log power-weighted pixel density in the lesion internal periphery showed the greatest discrimination of malignancy, although neither was statistically significant nor as good as the peak variables described below. The mean visual grey-scale rating was the best discriminator overall, but two peak vascularity measures each made promising scatterplots in conjunction with the average visual grey-scale rating. These two vascularity measures were the log peak normalized power-weighted pixel density (peak NPD) and log of peak mean Doppler frequency times the peak NPD (vM x NPD(M)). Each of these two values was the maximum in any one of the five chosen ROIs closely associated with the mass. A possible rationale for the relative success of these peak values is the blood signal's normalization and the inhomogeneity of most breast cancers and the expectation that the highest velocities (shunting) and largest collections of blood are not necessarily in the same region in and around the tumor. Peak NPD of cancers varied with age, decreasing by a factor of 45 from 33 to 77 y.
在本文中，介绍了从彩色多普勒图像中获得的新测量方法，并描述了一项初步研究，在该研究中对这些测量方法以及先前发表的指标进行评估，以供未来工作使用。对20名在乳房X光检查中发现有乳房肿块并即将接受手术活检的女性进行了研究。这些肿块中，11个被证明是良性的，9个是恶性的。同时进行了三维平均频移（f-CDI）和功率模式多普勒（p-CDI）成像。为了识别肿块和其他感兴趣区域，血管被显示为可旋转的三维彩色容积，叠加在可选的灰度/彩色血流切片上。在肿块及其周围的6个椭圆形感兴趣区域以及正常组织的2个区域中记录多普勒信号。在每个区域计算7项测量值，3项来自功率模式，2项来自平均频率，2项来自两者的组合。放射科医生根据6项传统灰度标准，对肿块的灰度外观进行1至5级评分（5分表示最可疑）。在各个感兴趣区域的个体血管测量中，病变内周边的对数速度加权像素密度和对数功率加权像素密度对恶性肿瘤的鉴别能力最强，尽管两者在统计学上均无显著差异，也不如下面描述的峰值变量。平均视觉灰度评分总体上是最好的鉴别指标，但两项峰值血管测量值与平均视觉灰度评分结合时，各自都做出了有前景的散点图。这两项血管测量值是对数峰值归一化功率加权像素密度（峰值NPD）和峰值平均多普勒频率乘以峰值NPD的对数（vM x NPD(M)）。这两个值中的每一个都是在与肿块密切相关的五个选定感兴趣区域中的任何一个区域中的最大值。这些峰值相对成功的一个可能的基本原理是血液信号的归一化以及大多数乳腺癌的不均匀性，以及预期最高速度（分流）和最大血液聚集不一定在肿瘤及其周围的同一区域。癌症的峰值NPD随年龄变化，从33岁到77岁下降了45倍。
