LEADING EDGE IN DIAGNOSTIC ULTRASOUND

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1 "THE LEADING EDGE IN DIAGNOSTIC ULTRASOUND SPECIAL REPRINT Syllabus Section V 2 nd International Forum for Research & Education May 22, 2002 The Leading Edge in Diagnostic Ultrasound Annual Conference Atlantic City, NJ, USA May 21-24, 2002 Sponsored by Thomas Jefferson University The Jefferson Ultrasound Research and Education Institute

2 2 nd International Forum for Research & Education May 22, 2002 Page Abstract Title Presenter 5 Sonographic Appearance of Ascaris and Typical Serpentine Movement 7 Ultrasound and Helical CT Examination of Pediatric Liver Masses 9 Radiology (Ultrasound, X-Ray Fluoroscopy, CT and Combined Ultrasound/X-Ray) Guidance Technique for Transcutaneous Liver Biopsy, Aspiration and Drainage Procedures 13 Three-Dimensional Ultrasound in Gastroenterology 17 Use of Colour Doppler in the Evaluation of Fallopian Tube Patency During Saline Infusion Sonohysterosalphingography 19 Value of Pulsed Doppler in Diagnosis of Breast Lesions 25 Characterization of Breast Carcinoma Using power Doppler Imaging, in Correlation with Lymph Node Status 27 Intracavernous Pharmacostimulation with or without Color Coded Duplex Ultrasound for Erectile Dysfunction Diagnosis 29 Ultrasound Follow-Up of Adult Brain Pathology 31 Experimental study on the Quantitative Assessment of Canine Myocardial Perfusion with Graded Coronary Stenosis with Intravenous Real-Time MCE Musarrat Hasan, MD Karachi, Pakistan Zoltan Harkanyi, MD Budapest, Hungary Malkhaz Mizandari, MD Tiblisi, Georgia Leandro Fernandez, MD Caracas, Venezuela Nirvikar Dahiya, MD Coimbatore, India Angelica Chiorean, MD Cluj-Napoca, Romania Vanesa Beslagic, MD Sarajevo, Bosnia & Herzegovina Hamayiak Sisakian, MD Yerevan, Armenia Andrias Ambartsoumian, MD Yerevan, Armenia Jun Zhang, MD Xi'an City, China 33 Carotid Disease and Myocardial Revascularization C.V. Vanjani,M.D Bombay, India

3 The Value of Pulsed Doppler Ultrasonography in the Diagnosis of the Breast Tumor Type Angelica Chiorean, Sorin M. Dudea, Gabriella Serban, Sorana Bolboaca Department of Radiology "Iuliu Hatieganu "University Cluj-Napoca, Romania PURPOSE The aim of our study was to evaluate the usefulness of spectral Doppler indices in differentiating malignant from benign breast tumors MATERIAL AND METHOD Our study included 52 patients, aged years (average 40.9 years) who were found to have breast tumors at clinical, mammographic and/or ultrasound examinations. The final diagnosis was established by cytology (41 patients) or histology (11 patients). All ultrasound examinations were performed with a Medison Sonoace 8800 MT unit, using a high-frequency ( MHz) linear-array transducer. In case of a mass, the zone was examined by B-mode, color, power and spectral Doppler ultrasound. The machine was set to detect low-velocity blood flow (4 cm./sec). The wall filter was adjusted usually to a low level. The color Doppler gain was increased until noise appeared and than slightly decreased. The sample volume was set to a medium opening. Care was taken not to apply pressure with the transducer. The following indices were analyzed: -peak systolic velocity (PSV), -mean velocity (MV), -end diastolic velocity (EDV), -resistance index (RI), -pulsatility index (PI) and -systolic-diastolic ratio (SDR) We analyzed only the vessels within the tumor. The Doppler indices were differently calculated depending on the vascularisation of the tumor. In hypervascular tumors we calculated the average of the indices recorded in at least three different vessels. The angle correction was set at an angle of maximum 60, except the cases when there were only traces of color. The patients' data were recorded in standard registers and statistics performed regarding the presence of significant differences between the mean values of Doppler indices referring to the tumor histology (benign-malignant). The t-student test for unequal samples with confidential interval of 95%, and the differences were considered 19

4 significant if the calculated/? value was less than For this reason the SPSS 6 for Windows program was used. RESULTS Benign tumors: -14 fibroadenoma -2 phyllodes tumors -1 fibrolipoma Malignant tumors: -32 ductal carcinoma - 1 papillary carcinoma - 2 inflammatory carcinoma 20

5 Fibroadenomas 21

6 22

7 CONCLUSIONS The mean value of Doppler indices (PSV, MV, EDV, SDR, PI, RI) have higher values in malignant tumors in comparison with the benign tumors. We could not determine a cut-off value of the Doppler indices that would allow the differentiation 23

8 between benign and malignant lesions, because of a wide overlap. RI value over 0.8 is highly suggestive for a malignant tumor. Pulsed Doppler is time-consuming and we think that it is not useful for the daily practice. I NOTES 24

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