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KMID : 1114620090060020122
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Journal of the Korean Society for Breast Screening
2009 Volume.6 No. 2 p.122 ~ p.127
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Three-Dimensional Power Doppler Ultrasound and A Microbubble Contrast Agent in the Evaluation of Breast Tumor Vascularity
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Kim Sun-Mi
Cho Nariya
Chang Jung-Min
Park Sang-Hee
Jang Mi-Jung
Moon Woo-Kyung
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Abstract
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Purpose: To evaluate the diagnostic value of three-dimensional (3D) power Doppler (PD) ultrasound (US) combined with a microbubble contrast agent in characterization of tumor vascularity in solid breast masses.
Materials and Methods: Sixty consecutive patients with solid breast masses visualized by gray-scale US were evaluated with two-dimensional (2D) and 3D PDUS before and after injection of the contrast agent SH U 508 A. The tumor size varied 0.5-3.2 cm (mean, 1.2 cm). At each US studies, lesion vascularity (avacular, hypovascular, hypervascular) and morphology (regular vs irregular) of vessels were prospectively assessed by two radiologists. Diagnostic accuracy was calculated at unenhanced 2D and contrast-enhanced 3D PDUS.
Results: At unenhanced 2D PDUS, 19 (70%) of 27 cancers were vascular whereas 12 (36%) of 33 benign lesions were vascular. At contrast-enhanced 3D PDUS, all cancers (100%) were vascular whereas 20 (61%) benign lesions were vascular (p < .01). Irregular vessels were seen in 7 cancers (26%) and 1 benign lesion (3%) at unenhanced 2D PDUS and 22 cancers (81%) and 3 benign lesions (9%) at contrast-enhanced 3D PDUS (p < .001). By using the presence of irregular vessels in the mass as the diagnostic criterion for malignancy, sensitivity, specificity, positive and negative predictive values were 26% (7/27), 97% (32/33), 88% (7/8), and 62% (32/52), respectively, at unenhanced 2D PDUS and 81% (22/27), 91% (30/33), 88% (22/25), and 73% (30/41), respectively, at contrast-enhanced 3D PDUS.
Conclusion: Contrast-enhanced 3D PDUS was superior to unenhanced 2D PDUS in the characterization of tumor vascularity in solid breast masses.
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KEYWORD
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Breast neoplasms, US, US, contrast agent, US, power Doppler studies, Three-dimensional US
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