RESUMO
Excisional biopsy is the standard method of distinguishing benign from malignant masses of the breast. However, alternative, less invasive methods of diagnosis are needed to reduce the number of unnecessary biopsies, allay anxiety of the patient, and control costs. In this study, we evaluated breast masses in a series of patients using color Doppler sonography and gray scale ultrasonographic features. In all cases, the pathologic diagnosis of the breast mass was subsequently established by excisional biopsy. The accuracy of gray scale sonography exceeded that of color Doppler sonography at a significance level of P < 0.005.
Assuntos
Doenças Mamárias/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Ultrassonografia Mamária , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/prevenção & controle , Biópsia , Biópsia por Agulha , Doenças Mamárias/patologia , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/patologia , Controle de Custos , Estudos de Avaliação como Assunto , Feminino , Fibroadenoma/diagnóstico por imagem , Fibroadenoma/patologia , Doença da Mama Fibrocística/diagnóstico por imagem , Doença da Mama Fibrocística/patologia , Humanos , Processamento de Imagem Assistida por Computador , Mamografia , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Método Simples-Cego , Procedimentos DesnecessáriosRESUMO
This study was designed to quantify the relative contribution of the inferior and superior epigastric systems to infraumbilical TRAM flap skin blood flow, using laser Doppler flowmetry. In twelve flaps (11 patients), blood-flow measurements were obtained during routine elevation of the TRAM flap for breast reconstruction. Baseline readings were obtained and recorded after stabilization of blood flow. The deep inferior epigastric artery and vein (IEA) were clamped and measurements were obtained. An atraumatic aortic clamp was then placed across the superior strip of rectus abdominis muscle, occluding the superior epigastric system (SEA) and all collateral branches from the superior circulation, and readings obtained. IEA occlusion produced a reduction in skin flap blood flow which averaged 23 +/- 21 percent of baseline. When the SEA system was occluded, no significant decrease was noted. In fact, skin blood flow increased to 136 +/- 69 percent of baseline. When both the SEA system and IEA were clamped, skin blood flow averaged 10 +/- 9 percent of baseline, representing random movement of erythrocytes. The present study quantitatively documents the overwhelming dominance of the IEA system to supply the skin of the infraumbilical TRAM flap.
