title: Sonographic evaluation of breast nodules: comparison of conventional, real-time compound, and pulse-inversion harmonic images.
abstract: OBJECTIVE
  To compare the use of conventional, real-time compound, and pulse-inversion harmonic imaging in the evaluation of breast nodules.
  
  
  METHODS
  Fifty-two breast nodules were included in this study, conducted between May and December 2000, in which conventional, real-time compound, and pulse-inversion harmonic images were obtained in the same plane. Three radiologists, each blinded to the interpretations of the other two, evaluated the findings, characterizing the lesions and ranking the three techniques from grade 1, the worst, to grade 3, the best. Lesion conspicuity was assessed, and lesions were also characterized in terms of their margin, clarity of internal echotexture, and clarity of posterior echo pattern. The three techniques were compared using Friedman's test, and interobserver agreement in image interpretation was assessed by means of the intraclass correlation coefficient.
  
  
  RESULTS
  With regard to lesion conspicuity, margin, and internal echotexture of the nodules, real-time compound imaging was the best technique (p < 0.05); in terms of posterior echo pattern, the best was pulse-inversion harmonic imaging (p < 0.05). Real-time compound and pulse inversion harmonic imaging were better than conventional sonography in all evaluative aspects. Interobserver agreement was greater than moderate.
  
  
  CONCLUSIONS
  Real-time compound and pulse-inversion harmonic imaging procedures are superior to conventional sonography in terms of both lesion conspicuity and the further characterization of breast nodules. Real-time compound imaging is the best technique for evaluation of the margin and internal echotexture of nodules, while pulse-inversion harmonic imaging is very effective for the evaluation of the posterior echo patterns.
authors.affiliation: Department of Diagnostic Radiology, Korea University Anam Hospital, 126-1 Anam-dong 5-ga, Sungbuk-gu, Seoul 136-705, Korea. ssbk@dreamwiz.com
authors.forename: Bo Kyoung
authors.initials: BK
authors.lastname: Seo
authors.forename: Yu Whan
authors.initials: YW
authors.lastname: Oh
authors.forename: Hyung Rae
authors.initials: HR
authors.lastname: Kim
authors.forename: Hong Weon
authors.initials: HW
authors.lastname: Kim
authors.forename: Chang Ho
authors.initials: CH
authors.lastname: Kang
authors.forename: Nam Joon
authors.initials: NJ
authors.lastname: Lee
authors.forename: Jung Hyuk
authors.initials: JH
authors.lastname: Kim
authors.forename: Bum Jin
authors.initials: BJ
authors.lastname: Park
authors.forename: Kyu Ran
authors.initials: KR
authors.lastname: Cho
authors.forename: June Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Ki Yeoul
authors.initials: KY
authors.lastname: Lee
authors.forename: Jeoung Won
authors.initials: JW
authors.lastname: Bae
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D005348:Fibrocystic Breast Disease / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D016217:Ultrasonography, Mammary / Q000379:methods*