title: [What is the role of Doppler color sonography associated with echo-signal enhancing levovist in complementary breast diagnosis?].
abstract: At the women's hospital of the University of Erlangen we performed a prospective clinical study to evaluate the use of color Doppler imaging supported by the new echo contrast agent Levovist in comparison to clinical examination, B-mode sonography, mammography, and MRI. In 40 patients the sensitivity and specificity of each method was estimated in predicting the dignity of palpable or mammographically detectable tumors of the breast. Prior to and after administration of Levovist we recorded the number of vessels, the PI, RI, SD-ratio, and maximum flow velocity after correction of the angle. Color Doppler imaging of the tumor and the surrounding tissue was documented on video tape for five minutes after the administration of Levovist. We measured the time until an increase and decrease in color signal was detectable. The following sensitivities/specificities were found: clinical examination 57.1% (12/21)/73.7% (14/19), B-mode sonography 100% (21/21)/84.2% (16/19), mammography 100% (21/21)/89.5% (17/19) and MRI 92.3% (14/15)/78.6% (15/18). Without the contrast agent color Doppler imaging could not differentiate between malignant and benign lesions. There was no significant difference in the perfusion of benign and malignant tumors. However, after the administration of Levovist, there appeared to be a significant difference for SD-ratio. With a cut-off-level of 3.5 we found a sensitivity/specificity of 85% (17/ 20)/78.6% (11/14) for the Doppler method. There was a weak correlation between the time of appearance of the augmented Signal in color Doppler and the velocity of enhancement of the contrast agent in MRI (n = 24, r = 0.47, p = 0.02). Only with the use of a contrast agent was color Doppler ultrasound able to support the other methods in pre-operative differentiation of benign and malignant lesions in the breast.
authors.affiliation: Universitäts-Frauenklinik Erlangen.
authors.forename: C
authors.initials: C
authors.lastname: Grüner
authors.forename: A
authors.initials: A
authors.lastname: Schönwälder
authors.forename: R
authors.initials: R
authors.lastname: Schulz-Wendtland
authors.forename: N
authors.initials: N
authors.lastname: Lang
authors.forename: W
authors.initials: W
authors.lastname: Bautz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001941:Breast Diseases / Q000175:diagnosis; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D011134:Polysaccharides; D011859:Radiography; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508
vernacular_title: Welche Rolle spielt die Farbdopplersonographie, unterstützt mit dem Echosignalverstärker Levovist, in der komplementären Mammadiagnostik?