[Detection of microcalcifications by high-resolution B-mode sonography in patients with BI-RADS 4a lesions].
OBJECTIVE
Evaluation of the diagnostic quality of high-resolution B-mode sonography for the detection of microcalcifications and calcification-associated focal findings in patients with BI-RADS lesions of subtype 4a.


METHODS
40 patients underwent X-ray mammography and 13-MHz B-mode sonography. The following parameters were examined: with X-ray mammography: extent of microcalcification and visibility of associated focal areas; with ultrasound: sensitivity of microcalcification findings, quality of presentation, extent of microcalcification, visibility of associated focal areas and feasibility of ultrasound-assisted biopsy.


RESULTS
X-ray mammography showed a mean extent of microcalcification of 28 8 21 mm. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) and accuracy of microcalcification-associated focal findings were 61.5, 57.9, 50, 45.8 and 47.5%. B-mode sonography achieved a sensitivity of 100%. Sonographically, the mean extent of microcalcification was 7 +/- 3 mm and thus significantly smaller (p < 0.01). Sensitivity, specificity, PPV, NPV and accuracy were 14.3, 84.2, 50, 47.1 and 47.5%. Ultrasound-assisted biopsy appeared feasible in 22 patients (55%).


CONCLUSIONS
High-frequency B-mode sonography allows a highly sensitive confirmation of microcalcifications in the case of BI-RADS 4a lesions and seems to allow ultrasound-assisted biopsy in about half the patients.
Diavero Brustdiagnosezentrum Essen, Heidbergweg 22-24, Essen, Germany. dr.stoeblen@diavero.de
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F
Stöblen
S
S
Landt
A
A
Köninger
J
J
Hecktor
R
R
Kimmig
S
S
Kümmel
D000368:Aged; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000175:diagnosis / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002114:Calcinosis / Q000000981:diagnostic imaging*; D044584:Carcinoma, Ductal / Q000175:diagnosis* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional; D016217:Ultrasonography, Mammary / Q000379:methods*