D-galactose-based signal-enhanced color Doppler sonography of breast tumors and tumorlike lesions

RATIONALE AND OBJECTIVES. This study sought to evaluate prospectively the d iagnostic potential of unenhanced and enhanced color Doppler and power Dopp ler for the differentiation of tumors and tumorlike lesions of the breast. METHODS. Ninety-two patients with 110 tumors or tumorlike lesions of the br east were investigated by unenhanced and enhanced color and power Doppler u ltrasound. The sonomorphologic aspects of vascularization were analyzed. In addition, maximal systolic frequency shift, resistance, and pulsatility in dices were determined. RESULTS. In 15 (24%) of 63 primary carcinomas, 15 (68%) of 22 fibroadenomas , and all (100%) of 14 postoperative lesions, the sonomorphologic analysis for the differential diagnosis of breast tumors was improved after contrast enhancement in color Doppler mode. In comparing unenhanced color Doppler t o power Doppler, the latter was found to be slightly superior (sensitivity, 60% vs. 67%; specificity, 39% vs. 45%, respectively); after enhancement, b oth modes were equivalent (sensitivity, 100% vs. 100%; specificity, 95% vs. 95%, respectively). Signal enhancement resulted in a significant improveme nt in sensitivity and specificity (P < 0.01). Typical signs of malignancy w ere irregular vessel calibers, serpiginous courses, penetration of the tumo r's margin, and irregular reticular vascularization, The quantitative param eters proved not to be helpful for the differential diagnosis of breast tum ors. CONCLUSIONS. By improved analysis of the vascularization pattern, d-galacto se-enhanced color Doppler sonography was found to provide more reliable dif ferential diagnostic information than unenhanced Doppler ultrasound in tumo rs and tumorlike lesions of the breast.