title: Nonpalpable breast lesions: evaluation with power Doppler US and a microbubble contrast agent-initial experience.
abstract: OBJECTIVE
  To evaluate power Doppler ultrasonography (US) performed with a microbubble US contrast agent in the differentiation of nonpalpable breast lesions.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departments of Radiology and Surgery, the Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea. moonwk@radcom.snu.ac.kr
authors.forename: W K
authors.initials: WK
authors.lastname: Moon
authors.forename: J G
authors.initials: JG
authors.lastname: Im
authors.forename: D Y
authors.initials: DY
authors.lastname: Noh
authors.forename: M C
authors.initials: MC
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D001941:Breast Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D016009:Chi-Square Distribution; D003287:Contrast Media; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging; D011134:Polysaccharides; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D016217:Ultrasonography, Mammary
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508