OPTIMIZED DIFFERENTIAL-DIAGNOSIS OF BREAST-LESIONS BY COMBINED B-MODEAND COLOR DOPPLER SONOGRAPHY

To optimize the sensitivity and specificity of gray-scale imaging and color Doppler in breast tumor diagnosis, alone and in combination, 89 women with palpable breast masses were scanned preoperatively and stan dard parameters were determined in both modes. Parameters significant for differentiation of benign and malignant tumors identified using un ivariate analysis were combined and weighted using multivariate analys is (multiple logistic regession). Histologically 59 tumors were malign ant and 30 benign. Gray-scale sonography alone achieved a sensitivity of 88% and a specificity of 96% using the parameters of wall structure and posterior acoustic attenuation. Color Doppler achieved a sensitiv ity of 85% and a specificity of 79% using resistance index and pulsati lity index as parameters. Combination of both methods yielded an accur ate diagnosis in 84/87 patients (sonographic lesion correlates were ab sent in two cases), equivalent to a sensitivity of 97% and a specifici ty of 96%. Thus the individual diagnostic performance of gray-scale im aging and color Doppler sonography in palpable breast disease is furth er enhanced using multiple logistic regression to combine independentl y significant parameters.