Evaluation of solid breast lesions with power Doppler sonography

Purpose. We compared the abilities of power and conventional color Doppler sonography to depict the vascularity of solid breast lesions and evaluated the usefulness of power Doppler sonography in differentiating between benig n and malignant breast lesions. Methods. One hundred two solid breast lesions (59 benign and 43 malignant l esions) were studied with power and color Doppler sonography. Power and col or Doppler sonograms were retrospectively compared for the depiction of blo od flow signals. Power Doppler images were also reviewed for the amount of Doppler signals, pattern of vascularity, and morphology of vessels. The sen sitivity, specificity, and accuracy of the 2 techniques were calculated. Results. Compared with color Doppler sonography, power Doppler sonography d epicted flow superiorly in 61 cases (60%) and equally in 41 cases (40%). On power Doppler sonography, the incidence of marked blood flow in malignant lesions (65%) was higher than that in benign lesions (39%). The pattern of vascularity was predominantly central (86%) and/or penetrating (65%) more o ften in malignant lesions than in benign lesions (51% and 34%, respectively ). Branching (56%) and disordered vessels (42%) were seen more often in mal ignant lesions than in benign lesions (22% and 8%, respectively). The sensi tivity, specificity, and accuracy in diagnosing malignancy were 64%, 76%, a nd 71%, respectively, for power Doppler sonography and 77%, 76%, and 76% fo r color Doppler sonography. Conclusions. Power Doppler sonography was more sensitive than color Doppler sonography in the detection of flow in solid breast lesions. Although powe r Doppler sonography was not more effective in diagnosing malignant lesions , central and penetrating vascularity patterns and branching and disordered vessels seem to be helpful findings in predicting malignancy. (C) 1999 Joh n Wiley & Sons, Inc.