Purpose: To evaluate Spectral and color Doppler and (CEUS) in the differencial diagnosis of solid breast lesions.
Materials and Methods: Seventy lesions (palpable or nonpalpable) were visualized at gray-scale as solid masses and were prospectively evaluated with spectral and color Doppler and with a pulse inversion imaginng software after injection of a contrast agent. Lesion vascularity (number of arteries, their morphology, distribution and resistive index) besides wash-in and wash-out times after a contrast agent injection were analyzed and correlated with histologic results.
Results: Percutaneous biopsy revealed 25 malignant and 45 benign lesions. Morphologic analysis using gray-scale sonography and classified according the BI-RADS lexico showed sensitivity of 52%, and specificity of 100%, positive and negative predictive values of 100% and 78%, respectively. Considering Doppler sonography, the sensitivity, specificity, positive and negative predictive values were 88%; 57%; 53% and 89%. After contrast agent injection the sensitivity, specificity, positive and negative predictive values changed to 92%; 46%; 48% and 91% respectively. When we associated both methods like gray-scale and Doppler and gray-scale and contrast we obtain 96%, 86%,90% and 97% (first case) and 100%, 80%, 73% and 100% (second one). Resistive index and velocity were higher in malignant lesions before and after injection of a contrast agent. Wash in and wash out times were similar for benign and malignant lesions.
Conclusion: Doppler avaliation and CEUS can be useful to increase the specificity of morphologic features analysis of solid breast lesions.