三维能量多普勒超声定量研究卵巢肿物血管的价值

目的应用阴式三维能量多普勒超声定量测量卵巢肿物内血管参数并评价其对鉴别卵巢肿物良恶性的价值。 方法使用三维能量多普勒超声对44例术前诊断卵巢肿物的患者及20例正常卵巢的育龄妇女进行检查并测量相应的血管参数：血管形成指数（VI）、血流指数（FI）、血管形成一血流指数（VFI）。比较卵巢良性肿物组（23例）、恶性肿物组（21例）和正常卵巢对照组（20例）血管参数值的差异及其与肿物血管分型的关系。 结果卵巢恶性肿物组的VI、FIVFI值均明显高于良性肿物组和正常卵巢对照组。良性肿物组的VI值亦高于正常卵巢对照组。 结论三维能量多普勒超声定量测量卵巢肿物血管参数可为鉴别卵巢肿物良恶性及卵巢恶性肿物的早期诊断提供有价值的信息。     

三维能量多普勒超声定量分析盆腔肿物血流的价值

目的应用三维能量多普勒超声对盆腔肿物内血流参数进行定量分析,探讨三维能量多普勒鉴别盆腔肿物良恶性的价值。方法测量24例盆腔包块,其中包括血流指数(flow index,FI)、血管形成指数(vascularization index,VI)、血管形成-血流指数(vascularization-flow index,VFI)。对比分析两组血管参数值。结果 1三维能量多普勒血管成像可较清晰显示肿物内血流架构;2恶性肿物组的VI、FI和VFI值均明显高于良性肿物组。结论鉴别肿物良恶性采用三维能量多普勒超声具有一定的临床价值。     

经阴道三维能量多普勒超声参数鉴别诊断卵巢肿块良恶性的价值

目的应用经阴道三维能量多普勒超声(three-dimensional power Doppler transvaginal ultrasound,3DPDTVS)探讨参数鉴别诊断卵巢肿块良恶性的价值。方法对120个卵巢肿块进行3DPD-TVS检查并测量相应参数:血管化指数(vascularization index,VI)、血流指数(flow index,FI)、血管化血流指数(vascularization flow index,VFI)。按病理结果120个卵巢肿块分为良性组和恶性组,并应用接受者操作特性曲线(the receiver operating characteristic curve,ROC)比较各项参数的鉴别诊断卵巢肿块良恶性诊断价值。结果卵巢肿块恶性组VI、FI、VFI值明显高于良性组,两组间差异有统计学意义(P0.05);VI、FI、VFI曲线下面积(area under curve,AUC)其中VFI曲线下面积最大。当VFI的截断值为0.436时,敏感度为89.8%,特异度为68.0%。结论经阴道三维能量多普勒超声参数3DPD-TVS能分析卵巢肿块的血供情况,为鉴别卵巢肿块良恶性提供较高的诊断价值。     

甲状腺结节三维能量多普勒定量分析与病理微血管密度的相关性研究

目的分析甲状腺结节三维能量多普勒超声定量参数与病理微血管密度的相关性,探讨其临床应用价值。方法对99个甲状腺结节进行三维能量多普勒成像检查,通过虚拟器官计算机辅助分析(VOCAL)得到MG、VI、FI、VFI定量参数,与术后病理结节微血管密度进行统计学对比分析。结果恶性组平均MG为26.8±7.3,明显低于良性组的32.6±8.3(P0.05);恶性组VI、FI、VFI分别为25.9±18.2、36.7±7.3、10.6±10.1,均明显低于良性组39.3±21.5、40.8±7.2、17.6±14.4(P0.05);VI、FI、VFI与MVD呈较强正相关(P0.05),VI相关性最强;当VI≤36.3%时,诊断良恶性的灵敏度80.3%、特异度78.9%、Youden′s指数59.2%、阳性预测值71.4%、阴性预测值86.0%,诊断效能最佳。结论三维能量多普勒定量测值参数VI与肿瘤微血管密度相关性最强,对良恶性鉴别诊断具有一定临床应用价值。     

三维彩色血管能量成像对乳腺肿物血管的定量研究

目的探讨三维彩色血管能量成像（3D—CPA）定量检测乳腺肿物内血管参数对鉴别诊断肿物良恶性的临床价值。方法61例乳腺肿瘤患者,良性组31例,恶性组30例,对其行3D—CPA重建。采用Vocal分析软件,选择三维能量直方图获得血管形成指数（vI）、血流指数（FI）和血管形成一血流指数（VFI）;并对乳腺肿物进行3D—CPA血流分级,比较乳腺良恶性肿物vI、FI、VFI及其与乳腺肿物内血流分级的关系。结果3D—CPA血流Ⅲ级患者的VI、FI、VFI高于Ⅱ级（P〈0．05）,以Ⅲ级作为诊断乳腺良恶性标准,敏感性、特异性、准确性分别为91．3％、76．3％、82．0％。恶性组VI、FI、VFI均高于良性组（P〈0．05）。以vI≥1．157诊断乳腺恶性肿瘤的敏感性分别为87％,准确性为77％,特异性为68％;以FI≥32．397诊断乳腺恶性肿瘤的敏感性为83％,准确性为67％,特异性为52％;以VFI／〉0．426诊断乳腺恶性肿瘤的敏感性为83％,准确性为73％,特异性为61％。结论乳腺肿物3D—CPA血管定量参数VI、FI、VFI与乳腺肿物血流分级结果一致,可用来判断乳腺肿物内部血管丰富程度,恶性肿物参数均高于良性肿物,有助于乳腺良恶性肿瘤的鉴别。     

三维能量多普勒超声成像技术在早期宫颈癌血管检测中的应用

目的探讨三维能量多普勒超声定量检测早期宫颈癌肿块内血管的诊断价值及早期宫颈癌肿瘤体积与血管参数(VI、FI、VFI)的相关性。方法对25例临床诊断为早期宫颈癌(Ia～IIa期)的患者(宫颈癌组)及19例宫颈上皮内瘤变(CIN)Ⅱ～Ⅲ级的患者(宫颈上皮内瘤变组)行三维能量多普勒超声检查,测定宫颈或肿块内血管形成指数(VI)、血流指数(FI)、血管形成-血流指数(VFI)3项血管参数,同时观察宫颈癌组患者肿瘤体积与血管参数的相关性,并与20例正常女性(对照组)宫颈的3项血管参数检测值进行比较。结果早期宫颈癌组[VI(5.44±4.02)%、FI(41.61±3.51)及VFI(2.31±1.65)]3项血管参数平均测值明显高于宫颈上皮内瘤变组[VI(1.84±0.62)%、FI(39.17±4.12)、VFI(1.34±0.55)]和对照组[VI(0.77±0.11)%、FI(38.49±3.55)及VFI(0.47±0.33)],差异有统计学意义(P0.05);宫颈上皮内瘤变组2项血管参数测值VI、VFI亦高于对照组,差异有统计学意义(P0.05)。早期宫颈癌组患者宫颈肿瘤体积越大,宫颈肿瘤内FI测值也升高,宫颈肿瘤体积与FI测值间存在线性正相关关系,相关系数r=0.523(P=0.007)。结论三维能量多普勒超声是定量检测早期宫颈癌肿块内血流的新方法,可为早期宫颈癌患者超声检查提供更多诊断信息。     

卵巢肿瘤患者三维直方图血管参数与微血管密度的相关性CSCD

目的评价三维直方图血管参数与卵巢肿瘤患者微血管密度(MVD)的相关性。方法收集2008年1月至2009年12月在首都医科大学附属北京妇产医院就诊的57例囊实性或实性卵巢肿物患者,术前1周行三维能量多普勒超声检查,对肿物感兴趣区的实性部分行三维血流采集,应用虚拟器官计算机辅助分析(VOCAL)程序中的三维直方图计算血管化指数(VI)、血流指数(FI)及血管化血流指数(VFI)。术后对肿瘤病理组织切片进行免疫组化染色,计算MVD及血管内皮生长因子(VEGF)表达强度。采用2个独立样本t检验比较MVD在卵巢良、恶性肿瘤间的差异,采用秩和检验比较VEGF在卵巢良、恶性肿瘤间的差异,采用Spearman等级相关分析法评价超声血管参数与MVD的相关性。结果 57例患者共62个卵巢肿物(5例患者为双侧),经病理证实,其中,良性22个,恶性40个(包括交界性8个)。共有54个卵巢肿瘤行免疫组化染色,卵巢恶性肿瘤组的MVD值及VEGF表达强度均明显高于良性肿瘤组,差异均有统计学意义(t=-5.255,Z=-3.868,P<0.01)。其中VI、VFI与MVD均呈正相关,差异均有统计学意义(r=0.295、0.280,P均<0.05)。结论三维直方图血管参数与卵巢肿瘤的MVD关系较为密切,可在术前反映卵巢肿瘤内血管的生成情况,为临床的早期诊断提供有价值的信息。     

卵巢肿瘤患者三维直方图血管参数与微血管密度的相关性

目的评价三维直方图血管参数与卵巢肿瘤患者微血管密度(MVD)的相关性。方法收集2008年1月至2009年12月在首都医科大学附属北京妇产医院就诊的57例囊实性或实性卵巢肿物患者,术前1周行三维能量多普勒超声检查,对肿物感兴趣区的实性部分行三维血流采集,应用虚拟器官计算机辅助分析(VOCAL)程序中的三维直方图计算血管化指数(VI)、血流指数(FI)及血管化血流指数(VFI)。术后对肿瘤病理组织切片进行免疫组化染色,计算MVD及血管内皮生长因子(VEGF)表达强度。采用2个独立样本t检验比较MVD在卵巢良、恶性肿瘤间的差异,采用秩和检验比较VEGF在卵巢良、恶性肿瘤间的差异,采用Spearman等级相关分析法评价超声血管参数与MVD的相关性。结果 57例患者共62个卵巢肿物(5例患者为双侧),经病理证实,其中,良性22个,恶性40个(包括交界性8个)。共有54个卵巢肿瘤行免疫组化染色,卵巢恶性肿瘤组的MVD值及VEGF表达强度均明显高于良性肿瘤组,差异均有统计学意义(t=-5.255,Z=-3.868,P0.01)。其中VI、VFI与MVD均呈正相关,差异均有统计学意义(r=0.295、0.280,P均0.05)。结论三维直方图血管参数与卵巢肿瘤的MVD关系较为密切,可在术前反映卵巢肿瘤内血管的生成情况,为临床的早期诊断提供有价值的信息。     

三维彩色直方图血流定量分析在乳腺肿瘤诊断中的应用价值

目的 探讨三维彩色直方图血流定量分析参数在乳腺良恶肿瘤的鉴别诊断中的应用价值.方法 应用GE Voluson 730三维彩色超声仪对111例患者133个乳腺肿块进行彩色多普勒检查,其中恶性肿瘤36个,良性肿瘤97个,所有病例均经手术病理及随访复查证实.采用三维彩色直方图技术测量肿瘤的体积(volume,V)、血管指数(vascularization index,VI)、血流指数(flow index,FI)和血管血流指数(vascularization-flow index,VFI).结果 恶性肿瘤组的V值、VI值、FI值和VFI值均显著高于良性肿瘤组(P均<0.05).V,VI,FI,VFI对乳腺良恶肿瘤的鉴别诊断均为有效,各指标据ROC曲线确定的诊断截值均具有较高的敏感性和特异性,其中,V指标诊断乳腺良恶肿瘤的价值最高,VI,VFl次之,FI较差.结论 三维彩色直方图血流定量分析参数在鉴别诊断乳腺良恶性肿瘤中有较高的应用价值,可以作为鉴别乳腺良恶性肿瘤的定量分析依据.     

三维能量多普勒超声预测宫颈癌动脉化疗栓塞疗效

目的探讨三维能量多普勒超声在宫颈癌动脉化疗栓塞疗效预测中的应用价值。方法对26例病理证实的宫颈癌患者分别于动脉化疗栓塞前及化疗栓塞后4周行三维能量多普勒超声检查,测定肿瘤体积及肿瘤内血管形成指数(VI)、血流指数(FI)、血管形成-血流指数(VFI)3项血管参数值,并记录肿瘤的临床病理特征;化疗后4周依据国际抗癌联盟疗效判断标准将患者分为有效组和无效组,比较两组患者化疗栓塞前肿瘤体积及肿瘤内部血管参数的差异,研究肿瘤体积及肿瘤内部血管参数与动脉化疗栓塞疗效间的关系。结果 26例宫颈癌患者动脉化疗栓塞后,完全缓解2例,部分缓解18例,病情稳定4例,病情进展2例,动脉化疗栓塞有效率为76.9%(20/26),无效率为23.1%(6/26);有效组化疗前肿瘤体积、VI、FI及VFI分别为(40.3±23.2)ml、(5.4±3.5)%、40.9±4.3和2.3±1.6;无效组化疗前肿瘤体积、VI、FI及VFI分别为(30.2±20.8)ml、(11.3±4.2)%、44.0±3.9和5.1±2.2;无效组化疗前VI及VFI明显高于有效组相应血管参数值,差异有统计学意义(P<0.05),而两组间肿瘤体积及FI比较差异均无统计学意义。结论三维能量多普勒超声获得的血管参数在宫颈癌动脉化疗栓塞疗效预测中有一定的临床应用价值。     

Intra-tumor flow index can predict the malignant potential of breast tumor: dependent on age and volume

The aim of this study was to assess tumor vascularity through three dimensional (3D) power Doppler breast ultrasound (US) and propose a decision model for the classification of benign and malignant breast tumors. Patient recruitment for this study was performed consecutively during a 13-mo period (January 2003 to February 2004). A total of 102 benign and 93 malignant solid breast images were analyzed. Three-dimensional power Doppler US imaging was performed using a Voluson730 ultrasound system equipped with a relative stopping power index (RSP) 6 to 12 transducer. The Virtual Organ Computer-aided Analysis (VOCAL)-imaging program (version 2.1) was used to analyze the stored volume. Histogram indices of the vascularization index (VI), flow index (FI) and vascularization-flow index (VFI) for the intra-tumor and for shells with a thickness of 3 mm surrounding the breast lesion were calculated and showed that for both, malignancy had a higher VI, FI and VFI than benignancy, with statistical significance. Multivariate and stepwise logistic regression revealed the model (including patient age, volume and intra-tumor FI in 3D power Doppler vascularity) to be the best choice for malignant breast tumor characterization. The receiver operating characteristics (ROC) index for the performance of the model was 0.926. Histogram indices for the intra-tumor FI in the 3D power Doppler scan are a good choice of parameter for differentiating between malignant and benign tumors with respect to the power of sensitivity, no matter whether one index is suggested or the patients' age and volume are considered.     

多囊卵巢综合征经腔三维能量多普勒超声参数及血管化指标特征的分析

目的 探讨多囊卵巢综合征(PCOS)经腔三维能量多普勒超声特征.方法 运用二维超声、彩色多普勒血流显像及三维能量多普勒超声对75例PCOS患者、63例正常者进行观察,测量卵巢平均直径、最大切面卵泡数、搏动指数(PI)、阻力指数(RI)、卵巢容积(V总)、间质容积(V间质)、卵泡容积(V卵泡)、平均灰度值(MG)、血管化指数(VI)、血流指数(FI)和血管化-血流指数(VFI).结果 PCOS卵巢平均直径,卵泡数、V总、V间质、V卵泡、VI和VFI大于对照组,差异有统计学意义(P＜0.05或P＜0.01).PCOS卵巢PI、RI小于对照组,差异有统计学意义(P＜0.01).结论 PCOS患者具有多囊卵巢超声影像学特征性的改变,三维能量多普勒超声可以精确测量卵巢容积,定量评估卵巢间质血流,VI和VFI可作为辅助诊断PCOS的新指标.     

三维能量多普勒超声鉴别乳腺良恶性肿瘤的价值

目的评价三维能量多普勒超声鉴别乳腺良恶性肿瘤的价值。方法乳腺肿块（恶性98例,良性108例）患者进行三维能量多普勒超声成像及直方图血管容积参数的采集与分析,直方图指数包括平均灰度、血管指数、血流指数和血管一血流指数。结果单因素分析以患者的年龄、肿瘤大小、肿瘤体积及血管各项指数鉴别乳腺良恶性肿瘤,参数之间差异均有统计学意义（P〈0．05）;鉴别病灶良恶性以肿瘤体积参数的准确性最高（80．2％）,以血流指数的敏感性最高（73．8％）,以血管指数、血管一血流指数的特异性为最高（均为90．3％）。多元Logistic逐步回归分析,模型（包括患者的年龄、体积及血流指数）是对乳腺恶性肿瘤定性诊断的最佳模型,此模型的ROC曲线下面积为0．958。结论三维能量多普勒超声能充分评估乳腺肿瘤的血管及血流情况,可以提高乳腺肿瘤的鉴别诊断能力。     

三维造影增强能量多普勒超声在卵巢肿瘤诊断中的应用

目的 探讨三维造影增强能量多普勒（3D-CEPD）在卵巢良恶性肿瘤鉴别诊断中的价值。方法 对50例卵巢肿瘤患者分别于造影前、造影中及造影后进行三维能量多普勒（3D-PD）检查。采用3D-PD直方图计算肿瘤血管形成指数（VI）、血流指数（FI）和血管形成-血流指数（VFI）,比较卵巢良性与恶性肿瘤各血管参数的差异及各血管参数在造影前、造影中、造影后的差异,并评价3个参数的诊断效能。结果 50例患者中,18例为恶性肿瘤,32例为良性肿瘤。造影前、中、后卵巢恶性肿瘤的血管参数均明显高于良性肿瘤（P均<0.01）,良恶性肿瘤的各血管参数在造影前、造影中、造影后的差异有统计学意义（P均<0.01）。3个不同检查时段血管参数鉴别卵巢良恶性肿瘤的ROC曲线下面积均为VI最大,FI最小。造影前、中、后三个不同检查时段VI诊断卵巢恶性肿瘤的ROC曲线下面积分别为0.83、0.87、0.89。造影前以VI=2.2%为界值,鉴别卵巢良恶性肿瘤的敏感度、特异度、阳性预测值、阴性预测值及准确率为77.77%、87.50%、77.77%、87.50%、84.00%;造影中以VI=23.2%为界值,各诊断效能分别为94.44%、90.62%、85.00%、96.66%、92.00%;而造影后以VI=12.4%为界值,各诊断效能分别为94.44%、93.75%、89.47%、96.77%、94.00%,造影中及造影后的诊断效能较造影前明显增高（P<0.01）,而造影后的特异度、阳性预测值优于造影中（P<0.01）。结论 3D-CEPD可提高鉴别卵巢肿瘤良恶性的能力,血管参数VI最有诊断价值,其诊断效能以造影后更佳。     

三维容积和能量多普勒血流参数对绝经期子宫内膜良恶性病变的鉴别诊断价值

目的 探讨三维容积及能量多普勒血流参数对绝经后出血患者子宫内膜良恶性病变的诊断价值.方法 对84例子宫内膜病变患者行三维能量多普勒超声检查,以病理结果分为良性组(子宫内膜息肉30例,子宫内膜增生34例)和恶性组(子宫内膜癌20例),应用接受者操作特性曲线(ROC曲线)比较各项指标的诊断价值.结果 两组间内膜体积比较差异无统计学意义(P>0.05),三维能量多普勒血流参数比较差异有统计学意义(P<0.01).血管指数(V1)、血流指数(FI)和血管-血流指数(VFI)的曲线下面积(AUC)分别为0.976、0.888和0.894.其中VI的曲线下面积最大,当VI的截断值为2.97%时,敏感性为95%,特异性为86%.结论 三维能量多普勒血流参数对绝经期出血患者内膜良恶性病变具有较高的诊断价值.

Abstract：

Objective To evaluate the value of three-dimensional power Doppler imaging(3D-PDI) in the discrimination between benign and malignant endometrium in women with postmenopausal bleeding. Methods Eighty-four women with post menopausal bleeding who examined by 3D-PDI were enrolled. All patients scheduled for pathological examination were divided into benign group (30 cases with endometrial polyps and 34 cases with hyperplasia) and malignant group (20 cases with endometrial carcinoma). Endometrial volume, vascularity index ( VI) , flow index ( FI) and vascularity flow index ( VFI) were measured. The diagnostic value of parameters derived from 3D-PDI was evaluated by using the receiver operating characteristic ( ROC) curve. Results Differences of these parameters (VI, FI and VFI) were considered statistically significant between two groups, the parameters of endometrial volume had no significant differences between two groups; the area under ROC curve(AUC) of the meaningful data were 0.976,0.888 and 0.894 respectively. Among these parameters, VI had the highest diagnostic value for discriminating between benign and malignant endometrium, the cut-off value of which was 2. 97 with a sensitivity of 95% and a specificity of 86%. Conclusions 3D-PDI is a good diagnostic tools in the discriminations between benign and malignant endometrium in women with postmenopausal bleeding.     

Does three-dimensional power Doppler ultrasound help in discrimination between benign and malignant ovarian masses?

OBJECTIVES: To determine if tumor vascularity as assessed by three-dimensional (3D) power Doppler ultrasound can be used to discriminate between benign and malignant ovarian tumors, if adding 3D power Doppler ultrasound to gray-scale imaging improves differentiation between benignity and malignancy, and if 3D power Doppler ultrasound adds more to gray-scale ultrasound than does two-dimensional (2D) power Doppler ultrasound. METHODS: One hundred and six women scheduled for surgery because of an ovarian mass were examined with transvaginal gray-scale ultrasound and 2D and 3D power Doppler ultrasound. The color content of the tumor scan was rated subjectively by the ultrasound examiner on a visual analog scale. Vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were calculated in the whole tumor and in a 5-cm(3) sample taken from the most vascularized area of the tumor. Logistic regression analysis was used to build models to predict malignancy. RESULTS: There were 79 benign tumors, six borderline tumors and 21 invasive malignancies. A logistic regression model including only gray-scale ultrasound variables (the size of the largest solid component, wall irregularity, and lesion size) was built to predict malignancy. It had an area under the receiver-operating characteristics (ROC) curve of 0.98, sensitivity of 100%, false positive rate of 10%, and positive likelihood ratio (LR) of 10 when using the mathematically best cut-off value for risk of malignancy (0.12). The diagnostic performance of the 3D flow index with the best diagnostic performance, i.e. VI in a 5-cm(3) sample, was superior to that of the color content of the tumor scan (area under ROC curve 0.92 vs. 0.80, sensitivity 93% vs. 78%, false positive rate 16% vs. 27% using the mathematically best cut-off value). Adding the color content of the tumor scan or FI in a 5-cm(3) sample to the logistic regression model including the three gray-scale variables described above improved diagnostic performance only marginally, an additional two tumors being correctly classified. CONCLUSIONS: Even though 2D and 3D power Doppler ultrasound can be used to discriminate between benign and malignant ovarian tumors, their use adds little to a correct diagnosis of malignancy in an ordinary population of ovarian tumors. Objective quantitation of the color content of the tumor scan using 3D power Doppler ultrasound does not seem to add more to gray-scale imaging than does subjective quantitation by the ultrasound examiner using 2D power Doppler ultrasound.     

Three-dimensional power Doppler imaging of early-stage cervical cancer.

OBJECTIVES: To characterize intratumoral vascularization in early-stage cervical cancer by three-dimensional (3D) power Doppler ultrasound. METHODS: One hundred and forty-one patients with carcinoma of the uterine cervix and 30 normal controls were studied by transvaginal 3D power Doppler ultrasound. The tumor volume of the cervical cancer was determined. The blood flow within the tumor or normal cervix was measured and expressed as the vascularization index (VI), flow index (FI) and vascularization flow index (VFI). RESULTS: Of the 141 patients with cervical cancer, 44 patients had undergone prior cervical conization. Eighty-seven patients had measurable cervical tumors, of whom five had had prior conization. Abundant intratumoral power Doppler signals could be detected, and the VI, FI and VFI were significantly elevated in cervical cancer patients compared with women with a normal cervix and patients in whom no cervical tumor could be detected (P < 0.05, one-way ANOVA). We observed four types of intratumoral vascularity patterns, which did not significantly differ in VI, FI and VFI: localized, peripheral, scattered and single-vessel types. Cervical tumor volume was positively correlated with FI (linear regression, r = 0.373, P = 0.001), but not with VI or VFI. CONCLUSIONS: 3D power Doppler ultrasound provides a useful tool to investigate intratumoral vascularization and volume of cervical cancer.     

Characterization of Benign and Malignant Solid Breast Masses: Harmonic Versus Nonharmonic 3D Power Doppler Imaging

The aim of this study was to compare the diagnostic performance of nonharmonic ultrasound (US) and tissue harmonic imaging (THI) using three-dimensional (3D) power Doppler sonographic technique to classify benign and malignant breast tumors by vascularization. From January 2003 to February 2004, we evaluated 200 patients and one of lobular carcinoma in situ was excluded from the malignant category. One hundred and ninety-nine subjects were enrolled. All subjects with one or more breast masses were studied with 3D power Doppler US nonharmonic and harmonic technologies. Sixteen of 199 subjects were excluded because masses exceeded 3 cm limit of our US probe's footprint (n = 5) or no harmonic Doppler information (n = 11). A total of 97 benign and 86 pathologically proven malignant breast tumor images were analyzed. 3D power Doppler US imaging was performed using a Voluson730 US system. Three histogram indices, the vascularization index (VI), flow index (FI) and vascularization-flow index (VFI), on both nonharmonic and harmonic images were calculated for the intratumor and for shells with an outside thickness of 3 mm surrounding the breast lesion. A multilayer perception (MLP) neural network classifier used the vascularity indices to determine whether the breast tumors are benign or malignant. The receiver operating characteristic (ROC) curves are performed to estimate the diagnostic performances for nonharmonic and harmonic methods. ROC curve analysis used overall age, volume, VI, FI and VFI for both intratumor and shells with an outside thickness of 3 mm surrounding the breast lesions in nonharmonic US and THI. The area under the ROC curve (A_Z) was 0.9086 and 0.9009 (p = 0.3770). The sensitivity was 90.7% and 83.7% (p = 0.72), respectively, and the specificity was 92.8% and 92.8% (p = 1.00), respectively. In conclusion, the performance of 3D power Doppler US with respect to the characterization of solid breast masses as benign or malignant was not significantly improved with tissue harmonic imaging. (E-mail: darren_chen@cch.org.tw)