L'eco-color-Doppler nella valutazione ecografica nelle neoformazioni solide della mammella: 5 anni di esperienza.

In the last 5 years, 1,245 breasts have been examined with conventional and color-Doppler US. To assess color-Doppler capabilities and limitations, the results were critically reviewed only of the 311 patients who were operated and had unquestionable histologic findings. We investigated: 1) the number of "vascular poles", that is the vessels entering the examined mass from the periphery; 2) the presence of vessels with "abnormal" features, that is the vessels with varying diameters and/or with tortuous and erratic course; 3) the presence of vessels even on the mass interface only. The criterion indicated as no. 1, that is the presence of more than a vascular pole, exhibited 90.4% sensitivity and 70.7% prospective and 90.7% retrospective specificity. The criterion indicated as no. 2, that is the presence of vessels with anomalous features exhibited 75.1% sensitivity and 96.9% specificity. Using criterion no. 3 instead of no. 1, sensitivity would be increased from 90.4% to 96.5% but specificity would be decreased from 70.7% (and 90.7% retrospective specificity) to 46.9%, which was considered to be too low relative to the moderate increase in sensitivity. The positive predictive value of the presence of two vascular poles was 85% and that of the presence of vessels with anomalous course was 97.7%. Criteria no. 1 and 2 had 70.7% and 68.8% negative predictive value, respectively. In conclusion, the authors suggest the use of color-Doppler US to add further pieces of information to those obtained with conventional US.