[The demonstration of blood flow in focal breast lesions by power-Doppler sonography. A new approach to assessment?].
OBJECTIVE
Power-Doppler sonography is regarded as a very sensitive method for detecting low-velocity and low-volume blood flows. The purpose of our study was to investigate whether increased vascularity in breast carcinoma can be visualized by power-Doppler sonography and whether new criteria for differentiating benign and malign lesions can be found.


METHODS
315 patients were examined with a 13-MHz high-resolution linear transducer. If a suspicious lesion was found, it was evaluated further by power-Doppler sonography. Compared to normal breast parenchyma (reference structure), a focal increase in blood flow signals was registered using a 3-step grading system with a 4th step for no flow increase.


RESULTS
In 97 cases the sonographic findings were correlated with histology (n = 95) or cytology (n = 2). There were 50 benign lesions, 42 cases of invasive and 5 cases of in-situ carcinoma. 73.5% benign lesions showed no or just minimal increases in flow signal. 81% of invasive cancer presented middle- or high-flow increases compared to normal breast parenchyma. The extend of flow increase was linked to tumor size in invasive cancer. In stage T1b to T4, 94.3% of invasive carcinoma presented middle or high flow increases.


CONCLUSIONS
Power-Doppler sonography is able to visualize vascularization in breast tumors. According to first clinical results PD sonography is a promising additional diagnostic tool which seems to offer new criteria for differential diagnosis in breast tumors.
Institut für Radiologische Diagnostik, Ludwig-Maximilians-Universität München, Klinikum Crosshadern.
P
P
Milz
M
M
Kessler
A
A
Lienemann
N
N
Opitz
M
M
Reiser
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001940:Breast / Q000098:blood supply* / Q000473:pathology; D001943:Breast Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D012039:Regional Blood Flow; D018608:Ultrasonography, Doppler / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D016217:Ultrasonography, Mammary / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data
Blutflussdarstellung in Herdbefunden der Mamma mittels der Power-Doppler-Sonographie. Ein neuer Ansatz zur Dignitätsbeurteilung?