Subscribe to RSS
DOI: 10.1055/s-2007-963225
© Georg Thieme Verlag KG Stuttgart · New York
Aktueller Stand der 3D-/4D-Volumensonografie der Mamma
Current Status of 3D/4D Volume Ultrasound of the BreastPublication History
eingereicht: 14.1.2007
angenommen: 3.5.2007
Publication Date:
22 June 2007 (online)

Zusammenfassung
Die 3D-/4D-Volumensonografie der Mamma ist eine etablierte Methode, die zahlreiche Möglichkeiten eröffnet, Ultraschallvolumendaten zu analysieren und darzustellen. Die beschriebenen Darstellungsmöglichkeiten gehen von automatisiert akquirierten Ultraschallvolumendatensätzen aus. Der multiplanare Darstellungsmodus ist die primäre Art, mit dieser Information in Kontakt zu treten. Der Nischenmodus gestattet einen stufenförmigen Schnitt durch den 3D-Volumsdatensatz. Die Oberflächendarstellung entspricht einer Rendertechnik, im Rahmen derer in unterschiedlicher Schichtdicke (üblicherweise 1 - 4 mm) ein Algorithmus gewählt wird, der die Oberflächenstrukturen des Volume of Interest (VOI) kontrastbetont abbildet. Der Transparenzmodus bietet die Möglichkeit, echoarme oder echoreiche Strukturen je nach Zielsetzung in ihrer räumlichen Position innerhalb des Ultraschalldatenwürfels darzustellen. Als Sonderform eines Transparenzmodus ist Glass Body Rendering zu verstehen, das in Zusammenhang mit Blutflussdarstellung die Farbdaten oberflächenrendert und die Gray-Scale-Daten transparent präsentiert. Der Inversionsmodus gestattet eine dreidimensionale Oberflächendarstellung echoarmer Strukturen. Volume Contrast Imaging (VCI) kann sowohl an einem statischen 3D-Volumendatensatz als auch als 4D-Technik im Rahmen einer dynamischen Untersuchung zum Einsatz kommen. Die Volumenkalkulation und dreidimensionale Formanalyse von Herden wird mittels virtueller computerassistierter Organanalyse (VoCal) durchgeführt. Tomographic Ultrasound Imaging (TUI) ist zur optimierten Dokumentation statischer 3D-Ultraschallvolumsdatensätze geeignet. Die 3D-/4D-Volumensonografie der Brust ermöglicht, die koronale Ebene diagnostisch zu nützen. In dieser wird bei gutartigen Mammaherden nach dem Kompressionsmuster und bei malignen Läsionen nach dem Retraktions- oder Sternmuster gesucht. Das indeterminierte Muster weist sowohl Züge des Kompressionsmusters als auch Zeichen des Retraktions-/Sternmusters auf. Glass Body Rendering stellt in Verbindung mit Powerdoppler, Farbdoppler oder High Definition Flow Imaging die dreidimensionale intra- und peritumorale Gefäßarchitektur dar. 3D-Targeting kann sowohl in Zusammenhang mit 2D- als auch mit 4D-gezielter Biopsienadel die Korrektheit der Nadellage oder deren Fehllage nachweisen. Zusammenfassend ist festzustellen, dass die 3D-/4D-Volumensonografie der Mamma eine technisch fortgeschrittene und für die tägliche Anwendung in Mammadiagnostik und Mammaintervention geeignete Zusatzuntersuchung zur routinemäßig eingesetzten zweidimensionalen Sonografie ist.
Abstract
3D/4D volume ultrasound is an established method that offers various options for analyzing and presenting ultrasound volume data. The following imaging techniques are based on automatically acquired ultrasound volumes. The multiplanar view is the typical mode of 3D ultrasound data presentation. The niche mode view is a cut open view of the volume data set. The surface mode is a rendering technique that represents the data within a volume of interest (VOI) with different slice thicknesses (typically 1 - 4 mm) with a contrast-enhanced surface algorithm. Related to the diagnostic target, the transparency mode helps to present echopoor or echorich structures and their spatial relationships within the ultrasound volume. Glass body rendering is a special type of transparency mode that makes the grayscale data transparent and shows the color flow data in a surface render mode. The inversion mode offers a three-dimensional surface presentation of echopoor lesions. Volume Contrast Imaging (VCI) works with static 3D volume data and is able to be used with 4D for dynamic scanning. Volume calculation of a lesion and virtual computer-assisted organ analysis of the same lesion is performed with VoCal software. Tomographic Ultrasound Imaging (TUI) is the perfect tool to document static 3D ultrasound volumes. 3D/4D volume ultrasound of the breast provides diagnostic information of the coronal plane. In this plane benign lesions show the compression pattern sign, while malignant lesions show the retraction pattern or star pattern sign. The indeterminate pattern of a lesion combines signs of compression and retraction or star pattern in the coronal plane. Glass body rendering in combination with Power-Doppler, Color-Doppler or High-Definition Flow Imaging presents the intra- and peritumoral three-dimensional vascular architecture. 3D targeting shows correct or incorrect needle placement in all three planes after 2D or 4D needle guidance. In conclusion, it is safe to say that 3D/4D volume ultrasound of the breast is technically advanced and suitable for daily diagnostic and interventional breast work in addition to routinely used 2D sonography.
Key words
breast - 3D ultrasound - 4D ultrasound
Literatur
- 1
Kolb T M, Lichy J, Newhouse J H.
Comparison of the Performance of Screening Mammography, physical examination and breast
US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations.
Radiology.
2002;
225
165-175
MissingFormLabel
- 2
Kolb T M, Lichy J, Newhouse J H.
Occult cancer in women with dense breasts: detection with screening US - diagnostic
yield and tumor characteristics.
Radiology.
1998;
207
191-199
MissingFormLabel
- 3
Buchberger W, Niehoff A, Obrist P. et al .
Clinically and mammographically occult breast lesions: detection and classification
with high-resolution sonography.
Semin Ultrasound CT MR.
2000;
21
325-336
MissingFormLabel
- 4
Buchberger W, DeKoekkoek-Doll P, Springer P. et al .
Incidental findings on sonography of the breast: clinical significance and diagnostic
workup.
AJR.
1999;
173
921-927
MissingFormLabel
- 5
Leconte I, Feger C, Galant C. et al .
Mammography ans subsequent whole-breast sonography of nonpalpable breast cancers:
the importance of radiologic breast density.
AJR.
2003;
180
1675-1679
MissingFormLabel
- 6
Kaplan S S.
Clinical Utility of Bilateral Whole-Breast US in the Evaluation of Women with Dense
Breast Tissue.
Radiology.
2001;
221
641-649
MissingFormLabel
- 7
Moon W K, Noh D Y, Im J G.
Multifocal, multicentric, and contralateral breast cancers: bilateral whole-breast
US in the preoperative evaluation of patients.
Radiology.
2002;
224
569-576
MissingFormLabel
- 8 Friedrich M. Gerätetechnik. Friedrich M, Schneider J, Weitzel H Lehratlas der Mammasonographie Stuttgart; Wissenschaftliche Verlagsgesellschaft 1999: 19-27
MissingFormLabel
- 9
Rizzatto G.
Towards a more sophisticated use of breast ultrasound.
Eur Radiol.
2001;
11
2425-2435
MissingFormLabel
- 10
Weismann C F.
Breast ultrasound: new frontiers in imaging?.
Ultrasound Obstet Gynecol.
2000;
15
279-281
MissingFormLabel
- 11 Weismann C F. Recent advances in multidimensional 3D/4D breast imaging. Ueno E, Shiina T, Kubota M, Sawai K Research and development in breast ultrasound Tokyo; Springer 2005: 146-150
MissingFormLabel
- 12
Weismann C.
3D/4D breast ultrasound: diagnostic and intervention.
Radiol Oncol.
2004;
38 (Suppl 1)
S131-S138
MissingFormLabel
- 13
Weismann C F.
Multidimensionale Mammasonographie: Technische Aspekte und diagnostische Einsatzmöglichkeiten.
Ultraschall in Med.
2004;
25
390-392
MissingFormLabel
- 14
Baker J A, Kornguth P J, Scott Soo M. et al .
Sonography of solid breast lesions: observer variability of lesion description and
assessment.
AJR.
1999;
172
1621-1625
MissingFormLabel
- 15 American College of Radiology .Illustrated breast imaging reporting and data system (BI-RADS): ultrasound,. Reston, Va; American College of Radiology 2003 1st ed
MissingFormLabel
- 16
Madjar H, Ohlinger R, Mundinger A. et al .
BI-RADS-analogue DEGUM criteria for findings in breast ultrasound - consensus of the
DEGUM committee on breast ultrasound.
Ultraschall in Med.
2006;
27
374-379
MissingFormLabel
- 17
Graf O, Helbich T H, Fuchsjaeger M H. et al .
Follow-up of palpable circumscribed noncalcified solid breast masses at mammography
and US: can biopsy be averted?.
Radiology.
2004;
233
850-856
MissingFormLabel
- 18
Graf O, Helbich T H, Fuchsjaeger M H. et al .
Ultrasound follow-up of palpable solid probably benign breast lesions (BI-RADS category
3).
Fortschr Röntgenstr.
2004;
176
1251-1256
MissingFormLabel
- 19
Weismann C F.
Overview of new ultrasound technology and its application in breast imaging.
EJC Supplements.
2006;
4
33-34
MissingFormLabel
- 20 Teubner J, Bohrer M, Kaick G van. et al .Correlation between histopathology and echomorphology in breast cancer. Madjar H, Teubner J, Hackelöer BJ Breast Ultrasound Update Basel; Karger 1994: 63-74
MissingFormLabel
- 21
Rahbar G, Sie A C, Hansen G C. et al .
Benign versus malignant solid breast masses: US differentiation.
Radiology.
1999;
213
889-894
MissingFormLabel
- 22
Stavros T A, Thickman D, Rapp C L. et al .
Solid breast nodules: use of sonography to distinguish between benign and malignant
lesions.
Radiology.
1995;
196
123-134
MissingFormLabel
- 23
Hong A S, Rosen E L, Soo M S. et al .
BI-RADS for Sonography: Positive and negative predictive values of sonographic features.
AJR.
2005;
24
161-167
MissingFormLabel
- 24 Rotten D, Levaillant J M, Zerat L. Use of three-dimensional ultrasound mammography to analyze normal breast tissue and
solid breast masses. Merz E 3-D Ultrasonography in Obstetrics and Gynecology Philadelphia Lippincott; Willams&Wilkins 1998: 73-78
MissingFormLabel
- 25
Rotten D, Levaillant J M, Zerat L.
Analysis of normal breast tissue and of solid breast masses using three-dimensional
ultrasound mammography.
Ultrasound Obstet Gynecol.
1999;
14
114-124
MissingFormLabel
- 26
Cho N, Moon W K, Cha J H. et al .
Differentiating benign from malignant solid breast masses: comparison of two-dimensional
and three-dimensional US.
Radiology.
2006;
240
26-32
MissingFormLabel
- 27
Berg W, Gutierrez L, Nessaiver M S. et al .
Diagnostic accuracy of mammography, clinical examination, US and MR imaging in preoperative
assessment of breast cancer.
Radiology.
2004;
233
830-849
MissingFormLabel
- 28
Moon W K, Chang R F, Chen C J. et al .
Solid breast masses: classification with computer-aided analysis of continuous US
images obtained with probe compression.
Radiology.
2005;
236
458-464
MissingFormLabel
- 29
Huang S F, Chang R F, Chen D R. et al .
Characterization of spiculation on ultrasound lesions.
IEEE Transactions on medical imaging.
2004;
23
111-121
MissingFormLabel
- 30
Weismann C F.
4D-Sonographie zur Evaluierung von Mammaläsionen.
Ultraschall in Med.
2005;
26
437-438
MissingFormLabel
- 31
Butler R S, Venta L A, Wiley E L. et al .
Sonographic Evaluation of Infiltrating Lobular Carcinoma.
AJR.
1999;
172
325-330
MissingFormLabel
- 32 Weismann C F. Ultra-som tridimensional da mama. Montenegro CAB, Rezende Filho J, Almeida Lima ML Ultra-som tridimensional Atlas Comentado Rio de Janeiro; Editora Guanabara Koogan S.A 2001 6: 151-172
MissingFormLabel
- 33 Weismann C F. Three-dimensional sonography of the breast. Kurjak A, Kupesic S Clinical Application of 3D Sonography New York, London; Parthenon Publishing 2000 24: 215-228
MissingFormLabel
- 34
Delorme S, Anton H W, Knopp M V. et al .
Breast cancer: assessment of vascularity by colour Doppler.
Eur Radiol.
1993;
3
253-257
MissingFormLabel
- 35
Huber S, Delorme S, Knopp M V. et al .
Breast tumors: computer-assisted quantitative assessment with colour Doppler US.
Radiology.
1994;
192
797-801
MissingFormLabel
- 36
Huber S, Helbich T, Kettenbach J. et al .
Effects of a microbubble contrast agent on breast tumors: computer-assisted quantitative
assessment with color Doppler US-early experience.
Radiology.
1998;
208
485-489
MissingFormLabel
- 37
Kedar R P, Cosgrove D, McCready V R. et al .
Microbubble contrast agent for colour Doppler US: effect on breast masses.
Radiology.
1996;
198
679-686
MissingFormLabel
- 38
Madjar H, Jellins J.
Role of echo enhanced ultrasound in breast mass investigations.
European J of Ultrasound.
1997;
5
65-75
MissingFormLabel
- 39
Stuhrmann M, Aronius R, Roefke C. et al .
Vaskularisation von Mammatumoren: Einsatz des Ultraschallkontrastmittels in der Dignitätsbeurteilung.
Vorläufige Ergebnisse.
Fortschr Röntgenstr.
1998;
169
360-364
MissingFormLabel
- 40
Weismann C F.
Role of colour Doppler ultrasound in breast imaging.
EJC Supplements.
2006;
4
41-42
MissingFormLabel
- 41
Jackman R J, Nowels K W, Rodriguez-Soto J. et al .
Stereotactic, automated, large core needle biopsy of nonpalpable breast lesions: false-negative
and histologic underestimation rates after long-term follow-up.
Radiology.
1999;
210
799-805
MissingFormLabel
- 42
Libermann L, Dershaw D D, Glassman J R. et al .
Analysis of cancers not diagnosed at stereotactic core breast biopsy.
Radiology.
1997;
203
151-157
MissingFormLabel
- 43
Parker S H, Jobe W E, Dennis M A. et al .
US-guided automated large-core biopsy.
Radiology.
1993;
187
507-511
MissingFormLabel
- 44
Weismann C F, Forstner R, Prokop E. et al .
Three-dimensional targeting technique: can the number of core needle biopsies of a
breast lesion be reduced without diagnostic loss?.
Supplement to Radiology.
2000;
217
493
MissingFormLabel
- 45
Weismann C F, Forstner R, Prokop E. et al .
Three-dimensional targeting: a new three-dimensional ultrasound technique to evaluate
needle position during breast biopsy.
Ultrasound Obstet Gynecol.
2000;
16
359-364
MissingFormLabel
- 46
Helbich T H, Matzek W, Fuchsjaeger M H.
Stereotactic and ultrasound-guided breast biopsy.
Eur Radiol.
2004;
14
383-393
MissingFormLabel
Dr. Christian Weismann
Department für Mammadiagnostik und Mammaintervention, Universitätsinstitut für Radiodiagnostik,
LKH Salzburg
Müllner Hauptstraße 48
5020 Salzburg
Phone: ++43/6 62/4 48 25 77 71
Fax: ++43/6 62/44 82 39 64
Email: christian.weismann@inode.at