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(Radiology. 2000;217:240-246.)
© RSNA, 2000

Breast Imaging

Nonpalpable Breast Lesions: Evaluation with Power Doppler US and a Microbubble Contrast Agent-Initial Experience1

Woo Kyung Moon, MD, Jung-Gi Im, MD, Dong-Young Noh, MD and Man Chung Han, MD

1 From the Departments of Radiology (M.C.H.) and Surgery (D.Y.N.) and the Clinical Research Institute (W.K.M, J.G.I.), Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744, South Korea. From the 1999 RSNA scientific assembly. Received October 11, 1999; revision requested November 6; revision received February 14, 2000; accepted February 28. W.K.M., J.G.I., and D.Y.N. supported by grant no. 03-99-031 from the Seoul National University Hospital Research Fund. Address correspondence to W.K.M. (e-mail: moonwk@radcom.snu.ac.kr).

PURPOSE: To evaluate power Doppler ultrasonography (US) performed with a microbubble US contrast agent in the differentiation of nonpalpable breast lesions.

MATERIALS AND METHODS: Fifty nonpalpable breast lesions in 50 patients were prospectively evaluated with power Doppler US before and after injection of the contrast agent SH U 508A. Lesion vascularity and the morphology of vessels on US scans were analyzed and were correlated with histologic results.

RESULTS: Surgical excision revealed 22 cancers and 28 benign lesions. At nonenhanced power Doppler US, eight (36%) of 22 cancers and four (14%) of 28 benign lesions were vascular. At contrast agent–enhanced power Doppler US, 21 (95%) cancers and six (21%) benign lesions were vascular (P < .001). Irregular vessels were seen in three cancers and one benign lesion at nonenhanced power Doppler US and in 11 cancers and one benign lesion at contrast-enhanced power Doppler US. By using the presence of vascularity in the mass as the diagnostic criterion for malignancy, the sensitivity, specificity, and positive and negative predictive values of power Doppler US changed from 36%, 86%, 67%, and 63%, respectively, to 95%, 79%, 78%, and 96% after contrast agent injection.

CONCLUSION: Contrast-enhanced power Doppler US was superior to nonenhanced power Doppler US in the demonstration and characterization of tumor vascularity in nonpalpable breast lesions. Contrast-enhanced power Doppler US may be useful for the differentiation between nonpalpable breast cancers and benign tumors.

Index terms: Breast neoplasms, diagnosis, 00.30 • Breast neoplasms, US, 00.12983 • Ultrasound (US), contrast media, 00.12988 • Ultrasound (US), power Doppler studies, 00.12983




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