Usefulness of the twinkling artifact on Doppler ultrasound for the detection of breast microcalcifications.

Autor: Relea A; Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España. Electronic address: arelea@yahoo.es., Alonso JA; Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España., González M; Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España., Zornoza C; Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España., Bahamonde S; Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España., Viñuela BE; Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España., Encinas MB; Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España.
Jazyk: English; Spanish; Castilian
Zdroj: Radiologia [Radiologia (Engl Ed)] 2018 Sep - Oct; Vol. 60 (5), pp. 413-423. Date of Electronic Publication: 2018 Jun 12.
DOI: 10.1016/j.rx.2018.04.004
Abstrakt: Objective: To determine whether the twinkling artifact on Doppler ultrasound imaging corresponds to microcalcifications previously seen on mammograms and to evaluate the usefulness of this finding in the ultrasound management of suspicious microcalcifications.
Material and Methods: We used ultrasonography to prospectively examine 46 consecutive patients with groups of microcalcifications suspicious for malignancy identified at mammography, searching for the presence of the twinkling artifact to identify the microcalcifications. Once we identified the microcalcifications, we obtained core-needle biopsy specimens with 11G needles and then used X-rays to check the specimens for the presence of microcalcifications. We analyzed the percentage of detection and obtainment of microcalcifications by core-needle biopsy with this technique and the radiopathologic correlation. Microcalcifications that were not detected by ultrasound or discordant lesions were biopsied by stereotaxy at another center. We also used ultrasound guidance for preoperative marking with clips, usually orienting them radially.
Results: We identified and biopsied 41 of the 46 lesions under ultrasound guidance, including 24 of 25 carcinomas (17 in situ). B-mode ultrasound was sufficient for biopsying the microcalcifications in 14 patients, although the presence of the twinkling artifact increased the number of microcalcifications detected and thus enabled more accurate preoperative marking. Thanks to the twinkling sign, we were able to identify 27 additional groups of microcalcifications (89% vs. 30%; p < 0.05). All the surgical specimens had margins free of disease.
Conclusions: The twinkling artifact is useful for microcalcifications in ultrasound examinations, enabling a significant increase in the yield of ultrasound-guided biopsies and better preoperative marking of groups of microcalcifications.
(Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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