{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T13:35:21Z","timestamp":1760016921223},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2003,5,8]],"date-time":"2003-05-08T00:00:00Z","timestamp":1052352000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Ultrasound"],"published-print":{"date-parts":[[2003,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose.<\/jats:title><jats:p>The purpose of this study was to prospectively evaluate the usefulness of contrast\u2010enhanced power Doppler sonography (PDUS) using a microbubble echo\u2010enhancing agent in differentiating between malignant and benign small breast lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods.<\/jats:title><jats:p>Between July 1, 2000, and September 30, 2001, we performed gray\u2010scale sonographic examination of patients in whom diagnostic sonography or screening mammography had revealed solid breast lesions measuring less than 2 cm in the largest dimension. The patients were then examined on PDUS before and after injection of a microbubble contrast agent. The sonographic findings for all 3 techniques, as well as the morphologic features of the Doppler signals for each patient before and after injection of the contrast agent on PDUS, were independently assessed. Each lesion was classified as \u201cbenign\u201d or \u201cmalignant\u201d on the basis of specific criteria for sonographic interpretation. A hemodynamic study was performed in which time\u2010transit profiles of the Doppler signals on contrast\u2010enhanced PDUS were generated using a computer\u2010assisted program, and the results for each patient were compared with the findings of a histopathologic examination of surgical specimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Thirty\u2010six patients (35 women and 1 man) with a mean age of 43.5 years (range, 18\u201369 years) were evaluated. The tumors ranged from 4 to 19 mm in the largest dimension. Histopathologic examination revealed that 19 tumors were benign and 17 were malignant. For morphologic diagnosis of the malignant lesions, the sensitivity of gray\u2010scale sonography was 100%, compared with 29% for PDUS without contrast enhancement. The specificity of gray\u2010scale sonography was 47%, compared with 74% for PDUS without contrast enhancement. Contrast\u2010enhanced PDUS had a sensitivity of 71% and a specificity of 58%. The diagnostic accuracy was 72% for gray\u2010scale sonography, 53% for PDUS without contrast enhancement, and 64% for contrast\u2010enhanced PDUS. The time\u2010transit profiles of the hemodynamic study did not reveal a statistically significant difference in the accuracy rates of contrast\u2010enhanced PDUS between benign and malignant breast lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions.<\/jats:title><jats:p>Compared with PDUS without contrast enhancement, contrast\u2010enhanced PDUS provides better visualization of the morphology of vascular Doppler signals that is characteristic of malignancy and therefore has a higher sensitivity and diagnostic accuracy, albeit a lower specificity. In differentiating between benign and malignant small breast lesions, contrast\u2010enhanced PDUS can be helpful when used with gray\u2010scale sonography and PDUS without contrast enhancement. \u00a9 2003 Wiley Periodicals, Inc. 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