Strain ratio calculation contributes to the standardization of sonoelastography with high sensitivity and allows significant differentiation between benign and malignant breast lesions with a higher specificity compared to B-mode, subjective evaluation of elastography and mammography.
Purpose: Microcalcifications in the breasts can point to breast cancer. However, there is great morphologic variety, and microcalcifications do not always correlate with malignancy. We conducted a prospective study to compare ultrasound and mammography in the detection of microcalcifications following sonographic diagnosis of a hypoechoic focal lesion in women with dense breast composition.
Materials and Methods: A total of 104 lesions potentially associated with microcalcifications (82 malignant and 23 benign lesions) were included in the study. The breast was examined by ultrasound (9?MHz, Aplio XG/500) with additional use of MicroPure imaging for the demonstration and evaluation of microcalcifications. The presence of a focal lesion was verified and microcalcifications were counted at ultrasound and mammography by blinded readers. The sensitivity and specificity were determined, and ROC analysis and AUC analysis were performed.
Results: The women had a median age of 51 years. The average number of microcalcifications detected by sonography (2.12???2.77) and mammography (3.59???6.35) was not significantly different (p?>?0.05). Correlation of the techniques was adequate (Pearson?s r?=?0.616, p?0.0001; Spearman?s rho?=?0.654, p?0.0001). The intraclass correlation coefficient was K?=?0.382???0.072 (p?0.0001), also indicating adequate agreement of both techniques. The sensitivity and specificity were 70?%/30?% for MicroPure and 45?%/55?% for mammography. The positive predictive value of mammography was superior to that of MicroPure (88?% vs. 78?%).
Conclusion: The sonographic detection of microcalcifications with MicroPure imaging in breasts with a hypoechoic focal lesion correlates well with digital mammography.
A 62-year-old man was admitted after recurrent transient left-sided weakness and sensory loss. Ultrasound (US) examination revealed a 70% narrowing of the right proximal internal carotid artery (ICA). Contrast-enhanced US suggested plaque neovascularization (figure, A). Carotid endarterectomy of the right ICA was performed. Immunohistochemistry of the specimen showed, corresponding to the US findings, extensive plaque neovascularization associated with dense macrophage infiltration (figure, B, C). Plaque neovascularization is associated with inflammation and plaque progression.1 The detection of plaque neovascularization by contrastenhanced US could give further evidence of plaque vulnerability, but further study is needed to determine its value.
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