The role of enhanced Doppler Ultrasound in differentiation of benign vs. malignant scar lesion after breast surgery for malignancy
The role of enhanced Doppler Ultrasound in differentiation of benign vs. malignant scar lesion after breast surgery for malignancy
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DOI：
10.1046/j.1469-0705.2000.00116.x
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发表时间：
2000-05-01
影响因子：
7.1
通讯作者：
Holz, K
中科院分区：
文献类型：
--
作者：
Bäz, E;Madjar, H;Holz, K
目的评价超声造影在乳腺癌术后良恶性病变鉴别诊断中的价值。方法对38例乳腺癌术后1-15年（平均3.3年）可触及的可疑瘢痕性病变进行活检。在基线超声检查中，对血管分布、血管数量、血管走行规律及其多普勒参数进行主观评分。在注射超声造影剂（Levovist（R））后，将相同的评分系统应用于参数以及增强动力学、增强强度和增强模式。两个或多个特征（血管分布、血管数量、肿瘤增强强度或病变血管规则性评分）评分水平的任何增加均被定义为疑似恶性肿瘤。肿瘤周边明显增强也被认为是恶性肿瘤的可疑表现。超声检查结果进行了前瞻性评估，并与组织学的lose.Results的38例临床可疑的瘢痕病变，有28个真正的瘢痕和10个恶性瘢痕病变。所有瘢痕病变在基线超声检查中均显示无或轻微血管分布。超声造影增强后，肿瘤血管和肿瘤血管的数量显着增加，可以证明在所有10个恶性病变，但只有一个28良性scars.Conclusion疤痕提出了固有的技术问题，最佳的乳腺X线摄影。在有经验的检查者手中，用对比增强剂对病变的血管分布进行超声评价显示诊断准确性提高。
Aim To evaluate the benefit of echo-contrast-enhanced Doppler sonography in the differentiation of benign vs. malignant breast lesions after surgical removal of a malignant breast mass.Methods Thirty-eight patients referred for biopsy of a palpable, suspicious scar lesion 1-15 years (mean 3.3 years) after surgery for breast cancer were examined. During baseline ultrasound examination a subjective scoring system of the vascularity, the number, the regularity of vessels' course and their Doppler parameters were assessed. After injection of an ultrasound contrast agent (Levovist(R)) the same scoring system was applied to the parameters together with enhancement Kinetics, enhancement intensity and enhancement pattern. Any increase in the scoring level of two or more characteristics (vascularity, number of vessels, intensify of enhancement in the tumor or regularity score of vessels in the lesion) was defined as suspicious for malignancy. A marked increase of enhancement in the immediate tumor periphery was also regarded as suspicious for malignancy. The sonographic results were assessed prospectively and correlated with the histology of the lesion.Results Of the 38 patients with a clinically-suspicious scar lesion, there were 28 true scars and 10 malignant scar lesions. All scar lesions showed no or slight vascularity on baseline sonography. After Echocontrast-enhancement a significant increase in tumor vascularity and the number of tumor vessels could be demonstrated in all 10 malignant lesions but in only one of the 28 benign scars.Conclusion Scars pose inherent technical problems for optimal mammography. Sonographic evaluation of the vascularity of the lesion with contrast enhancing agents showed improved diagnostic accuracy in the hands of an experienced examiner.