Which ultrasound equipment features are beneficial for breast ultrasonography?

Updated: Jan 24, 2017
  • Author: Durre Sabih, MBBS, MSc, FRCP(Edin); Chief Editor: Mahan Mathur, MD  more...
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Ultrasound equipment with a high-resolution linear transducer is necessary. Transducers with 7-MHz to 12-MHz frequency are preferred because of better near-field resolution. [5]

Too deep a focus causes volume-averaging artifacts and gives erroneous results about tissue consistency. Matrix probes that can be focused in the short axis as well offer better resolution.

Even with high-resolution probes, the focal zone (indicated by moving small arrowheads at the side of the screen) must be kept either at the lesion or just deep to it for best resolution.

Machines with panoramic view (extended field of view) options are often useful because this allows very large areas to be collated into a single image. Some machines offer an extended imaging field (trapezoid imaging) while in others, the 2 split fields can be appended to image more of a larger lesion. However, note that one must avoid using the panoramic images for measurements.

Current-generation ultrasound machines offer additional image processing facilities, including spatial compounding, speckle reduction, harmonic imaging, and speed-of-sound imaging that offer enhanced resolution. These modes should be used and optimized for each patient. [9]

Additional features include elastography that color-codes tissue hardness, adding information that can be useful in certain conditions, as well as microcalcification imaging that enhances the presence of calcium particles.

An acoustic stand-off pad is helpful in imaging very superficial lesions.

Machine settings should be optimized for breast ultrasound: this includes appropriate focal depth, an optimal gain, and time gain compression (TGC; usually the default, without any curve), a high dynamic range, contrast and high edge enhancement settings. The depth of field should extend to the pleural echoes.

When optimized, the fat should appear medium gray in the premammary as well as the retromammary space.

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