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[Breast cancer recurrence versus scar. Ultrasonographic differentiation using Levovist as the contrast medium]
M Stuhrmann1, T Schwarz, M Schietzel
1Röntgenabteilung des Gemeinschaftskrankenhauses Herdecke, Universität Witten-Herdecke. pavel-settele-wuppertal@t-online.de
Aim:
To determine the scope of improving the distinction between a postoperative scar and the recurrence of a breast carcinoma through the use of the ultrasound echo enhancer Levovist?
Method:
In 23 patients with 26 lesions a colour-coded duplex sonography examination before and after administration of Levovist was performed. The parameters investigated were: degree of enhancement, number of tumour vessels and the pattern of vascular morphology and anatomy.
Results:
Recurrences (n = 15) demonstrated a greater number of vessels and a stronger enhancement after administration of Levovist. Individual vessels were also visible in scars (n = 11). Further evaluations with respect to the pattern of the tumour vascularization are therefore necessary with the exception of one false positive and one negative result a clear distinction was possible.
Conclusion:
The administration of the ultrasound echo enhancer clearly improved the otherwise difficult distinction between a scar and a tumour recurrence through sonography and mammography. Further studies with larger number of patients are necessary to establish the value of the method.