Combining imaging and vascularity assessment of breast lesions.

Two separate series of patients were investigated to determine the improvement in diagnostic accuracy obtained by combining the results of ultrasonic imaging and vascularity assessment for the detection and diagnosis of breast disease. In the first series, ninety-five patients were examined with a hand-held Doppler probe to verify that abnormal flow could be detected in the presence of breast disease. To determine the clinical efficacy of combining the two examination procedures, a second series of patients was examined with the Doppler transducers incorporated into the water-bath scanner so that the sample volume could be accurately positioned into specific regions previously imaged. In the one hundred patients examined with both procedures, there was an improvement in the accuracy of diagnosing breast disease due to the reduction in the number of false positive and negative reports compared to the accuracy of the imaging examination alone.

[Differentiation of breast cancers by Doppler ultrasound]. / Differenzierung von Mammakarzinomen durch CW-Doppler-Ultraschall.

Breast sonography is a well-accepted diagnostic method. For differentiation between benign and malignant lesions quantified sonography is gaining increased importance. In addition to measurements of velocity, attenuation and elastic properties of tissue, analysis of blood flow by CW Doppler ultrasound plays an important role. Malignancies usually show increased vascularity and extremely disorder. The peripheral resistance is low due to numerous AV-shunts in malignant tissue. With high frequency CW Doppler ultrasound (8-10 MHz) these anatomical and physiological features can be outlined objectively. Frequency analysis of Doppler signals in breast malignancies shows high intensities corresponding to increased blood flow. But also a broadening of the systolic peak with flattening of systolic increase and diastolic decrease as well as high diastolic flow. The different blood flow directions of the vessels recorded by the ultrasonic Doppler beam also cause broadening of the frequency range. In combination with B-mode ultrasound this method provides information essential for the differentiation of malignancies.

[Breast sonography with the new water bath scanning technics]. / Mammasonographie mit neuen Wasserbad-Scan-Techniken.

At 1188 patients we investigated the value of sonography of the breast in the detection of malignancies. We used 2 automatic multitransducer water-bath scanners, at first the 3 MH Octoson, then System 1, a dedicated 4 MH water-bath breast scanner which allows for compound and simple scans in any scanning plane. The sensitivity for detection of 63 malignancies was 87%. Other pathologies were 18 fibroadenomas, 160 cysts, 6 abscesses, 2 fatty necroses, 2 papillomas, 9 prostheses, one of them broken. The difficulties associated with differential diagnosis in breast sonography are discussed in detail.

Parathyroid lesions localized by radionuclide subtraction and ultrasound.

Radionuclide subtraction technique and gray-scale echography were used to localize parathyroid lesions in 6 patients with primary hyperparathyroidism. In 3 cases, surgery verified the scintigraphic findings. All lesions weighed less than 1 g, with the smallest weighing 350 mg. These procedures provide complementary information in preoperative localization of hyperfunctioning parathyroid tissue.

Grey scale ultrasonic examination of the thyroid gland.

High resolution grey scale echography is an accurate, non-invasive means of investigating thyroid lesions. The structural information which it provides complements that of the functional status of the gland obtained from radionuclide scanning. The principles and practice of the technique are discussed and clinical examples are presented.

Ultrasonic visualization of breast cancer.

Ultrasonic examination of the breast with grey scale echography gives considerable information about the composition of the constituent tissues. This information alone is sometimes of major assistance in the management of the individual patient, particularly in young women with nodular breasts due to dysplastic changes. The method is complementary to the more commonly used visualization techniques and should be considered, particularly in young women, as the first imaging technique to examine palpable masses in the breast, prior to the utilization of ionizing radiation.

Gray-scale echographic visualization of a parathyroid adenoma.

A large parathyroid adenoma and a smaller follicular thyroid adenoma were visualized with a combination of radionuclide imaging and gray-scale ultrasound in a patient with primary hyperparathyroidism.

Detection and classification of liquid-filled masses in the breast by gray scale echography.

Gray scale ultrasonic visualization of the breast is a simple and safe technique for the detection of liquid-filled masses. Cysts and enlarged ducts as small as 2 mm in diameter can be reliably detected with a greater accuracy than is possible with any other imaging technique. The ultrasonic examination provides considerable information about the nature of the constituent tissues, and this information alone is often sufficient for a determination of the correct treatment.

A comparative evaluation of a case of cystosarcoma phylloides: ultrasound, xeroradiography and thermography.

The results of xeroradiography, thermography, and ultrasonic gray scale echography in a case of cystosarcoma phylloides are presented. Echography better described the lesion than the other techniques. Gray scale echography displays the infrastructure of the breast tissues and differentiates between types of soft tissue.