Sonographic evaluation of breast nodules: comparison of conventional, real-time compound, and pulse-inversion harmonic images.
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.
Seo
Bo Kyoung
BK
Department of Diagnostic Radiology, Korea University Anam Hospital, 126-1 Anam-dong 5-ga, Sungbuk-gu, Seoul 136-705, Korea. ssbk@dreamwiz.com
Oh
Yu Whan
YW
Kim
Hyung Rae
HR
Kim
Hong Weon
HW
Kang
Chang Ho
CH
Lee
Nam Joon
NJ
Kim
Jung Hyuk
JH
Park
Bum Jin
BJ
Cho
Kyu Ran
KR
Lee
June Young
JY
Lee
Ki Yeoul
KY
Bae
Jeoung Won
JW
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*