2011, Number 3
Anales de Radiología México 2011; 10 (3)
Mendoza NHE, Rodríguez SMJ, Lazcano UÁ, Rodríguez SDC, Martín RJ, López VG, Remírez CA, Arango AJ
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ABSTRACTBackground. Elastosonography is a tool which, since its introduction in 1991, is applied to conventional ultrasound to analyze and provide morphological data different from that obtained in mode B. It is used to assess the elasticity of different components of mammary tissue showing the properties of lesions by evaluating their elasticity when subjected to external compression. Because elasticity is lower in rigid than in soft lesions, this data could prove useful as an auxiliary tool in diagnosing breast cancer: it is a known principle that malignant lesions are less elastic, and therefore present greater resistance to displacement than benign lesions.
Purpose. Evaluate the diagnostic usefulness of elastosonography as a complementary tool to conventional ultrasound in the study of probably benign, American College of Radiology (ACR) category BI-RADS 3 mammary lesions, by relating its results with cyto/histological diagnosis as standard reference.
Material and methods. Comparative, transverse, retrospective, retrolective study. Thirty-eight patients with lesions assessed by elastosonography and their correlation with the cyto/histological result were analyzed by kappa coefficient of diagnostic correlation. Positive and negative predictive values were established for the lesions studied, corresponding to category BI-RADS 3.
Results. Of 38 patients, 35 (92.2%) presented lesions in benign category in elastosonography and the cyto/histological result was also benign; 3 patients (7.8%) presented benign lesions in elastosonography but their cyto/histological result was malignant. The morphological characteristics of the lesions were: 31 nodular lesions (81.57%) and 7 cystic lesions (18.43 %), of which 5 corresponded to complex cysts.
Analysis and discussion. Elastosonography showed diagnostic accuracy of 92.1%, similar to that found by Tardivon et al. (87.5%). Elastosonography proved more useful to classify nodular images of small size and posterior localization as cystic than conventional ultrasound which assesses only the morphological appearance of the lesion without considering other properties of the tissues.
Conclusion. In our work elastosonography proved to be a useful diagnostic complement for managing BI-RADS 3 lesions. Negative elastosonographic results led to a change of the initial classification of lesions while positive elastosonographic results were decisive to change the expectation to direct intervention to obtain a histopathological correlation. This new echographic tool is promising because it adds certainty to the diagnosis and is especially useful in lesions cataloged in mode B as probably benign.