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Sonographic evaluation of breast nodules: comparison of conventional, real-time compound, and pulse-inversion harmonic images.

Seo BK, Oh YW, Kim HR, Kim HW, Kang CH, Lee NJ, Kim JH, Park BJ, Cho KR, Lee JY, Lee KY, Bae JW - Korean J Radiol (2002 Jan-Mar)

Bottom Line: The three techniques were compared using Friedman's test, and interobserver agreement in image interpretation was assessed by means of the intraclass correlation coefficient.Interobserver agreement was greater than moderate.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Korea University Anam Hospital, 126-1 Anam-dong 5-ga, Sungbuk-gu, Seoul 136-705, Korea. ssbk@dreamwiz.com

ABSTRACT

Objective: To compare the use of conventional, real-time compound, and pulse-inversion harmonic imaging in the evaluation of breast nodules.

Materials and 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.

Conclusion: 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.

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Related in: MedlinePlus

Sonograms of 32-year-old woman reveal a well-defined, oval-shaped, heterogeneous isoechoic nodule. The heterogeneous internal echotexture is more clearly visualized by real-time compound imaging (B) than conventional (A) and pulse-inversion harmonic imaging (B) and an internal microcalcification (curved arrow) is revealed by pulse-inversion harmonic imaging (C). Pathologic examination showed that the condition was atypical ductal hyperplasia.
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Figure 4: Sonograms of 32-year-old woman reveal a well-defined, oval-shaped, heterogeneous isoechoic nodule. The heterogeneous internal echotexture is more clearly visualized by real-time compound imaging (B) than conventional (A) and pulse-inversion harmonic imaging (B) and an internal microcalcification (curved arrow) is revealed by pulse-inversion harmonic imaging (C). Pathologic examination showed that the condition was atypical ductal hyperplasia.

Mentions: With regard to internal echotexture, attenuation was isoechoic in 22 cases (42%), hypoechoic in 18 (35%), hyperechoic in nine (17%), and anechoic with internal septation in three (6%). Thirty-four of the 52 nodules showed a homogeneous internal echotexture and the remaining 18 were heterogeneous. Internal microcalcification within the nodules was present in nine. In terms of clarity of the internal echotexture, RTCI was significantly superior to both PIHI and CI (p < 0.05) and PIHI was better than CI, though statistically, these two modalities were not significantly different (p > 0.05) (Table 3) (Figs. 2-4).


Sonographic evaluation of breast nodules: comparison of conventional, real-time compound, and pulse-inversion harmonic images.

Seo BK, Oh YW, Kim HR, Kim HW, Kang CH, Lee NJ, Kim JH, Park BJ, Cho KR, Lee JY, Lee KY, Bae JW - Korean J Radiol (2002 Jan-Mar)

Sonograms of 32-year-old woman reveal a well-defined, oval-shaped, heterogeneous isoechoic nodule. The heterogeneous internal echotexture is more clearly visualized by real-time compound imaging (B) than conventional (A) and pulse-inversion harmonic imaging (B) and an internal microcalcification (curved arrow) is revealed by pulse-inversion harmonic imaging (C). Pathologic examination showed that the condition was atypical ductal hyperplasia.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2713985&req=5

Figure 4: Sonograms of 32-year-old woman reveal a well-defined, oval-shaped, heterogeneous isoechoic nodule. The heterogeneous internal echotexture is more clearly visualized by real-time compound imaging (B) than conventional (A) and pulse-inversion harmonic imaging (B) and an internal microcalcification (curved arrow) is revealed by pulse-inversion harmonic imaging (C). Pathologic examination showed that the condition was atypical ductal hyperplasia.
Mentions: With regard to internal echotexture, attenuation was isoechoic in 22 cases (42%), hypoechoic in 18 (35%), hyperechoic in nine (17%), and anechoic with internal septation in three (6%). Thirty-four of the 52 nodules showed a homogeneous internal echotexture and the remaining 18 were heterogeneous. Internal microcalcification within the nodules was present in nine. In terms of clarity of the internal echotexture, RTCI was significantly superior to both PIHI and CI (p < 0.05) and PIHI was better than CI, though statistically, these two modalities were not significantly different (p > 0.05) (Table 3) (Figs. 2-4).

Bottom Line: The three techniques were compared using Friedman's test, and interobserver agreement in image interpretation was assessed by means of the intraclass correlation coefficient.Interobserver agreement was greater than moderate.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Korea University Anam Hospital, 126-1 Anam-dong 5-ga, Sungbuk-gu, Seoul 136-705, Korea. ssbk@dreamwiz.com

ABSTRACT

Objective: To compare the use of conventional, real-time compound, and pulse-inversion harmonic imaging in the evaluation of breast nodules.

Materials and 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.

Conclusion: 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.

Show MeSH
Related in: MedlinePlus