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FW: Breast fremitus examinationFrom: DuboseTerryJ@uams.eduWed Apr 25 12:36:41 2001
FYI, very interesting, and new information. Thanks to Dan Merton. Terry J. DuBose, M.S., RDMS, Assistant Professor Director, Diagnostic Medical Sonography Program CHRP, University of Arkansas for Medical Sciences Little Rock, Arkansas, USA 501-686-6510 http://www.io.com/~dubose/ http://www.uams.edu/CHRP/dmshome.htm http://www.obgyn.net/us/panel/panel.htm -----Original Message----- From: Daniel A Merton [mailto:Daniel.A.Merton@mail.tju.edu] Sent: Wednesday, April 25, 2001 11:35 AM To: soundadvice@listbox.com Subject: Re: Breast fremitus examination Hi all, The fremitus breast ultrasound technique is a method of identifying differences in tissue elasticity or stiffness. This is from an article by Brian Garra, MD that was in a supplement to Diagnostic Imaging "Advanced Ultrasound" (pg. 20) dated 11/00 (http://www.diagnostic-imaging.com/AdvancedUS/breast.shtml). "To perform a fremitus examination the patient is asked to hum a pitch while color or power Doppler is used to examine the breast. Softer portions of the breast vibrate more in response to the humming, while cancers and other firm masses vibrate less and thus become visible as areas of decreased color, even if they are isoechoic on the ordinary b-scan." I first learned of this from a lecture by Tom Stavros so if Cindy Rapp is out there perhaps she could provide a (peer-reviewed) lit. reference. If I recall correctly he suggested the patient hum the sound "EEEEEEEEEEEE" while using color flow to evaluate breast masses or suspected masses. The less stiff tissue will vibrate and the motion will be displayed w/ color while the "stiffer", lesion will not have color in it. I think the less temporally averaged color Doppler (as opposed to Power) would be a better choice but apparently you could use either color mode. An extension of the same idea is sono-elastography where consecutive US images are obtained before and after slight compression of the tissue by an external force mechanism (holding the US probe). Digital subtraction of data on the images is then performed off-line resulting in an "elastogram"- not an US image but rather a resulting display that demonstrates differences in tissue compressibility. Some of the images I have seen are quite dramatic (isoechoic lesions becoming very obvious, etc.) It works under the assumption that cancers are more firm than normal tissues (breast and others) Its limits are accessibility to tissues- thats why most of the work has been done on the mammalian protuberance... commonly referred to as the breast. ;-) DAM, Phila.pa "They do certainly give very strange, and newfangled, names to diseases." Plato (429- 347 B. C. E.) To some imaging techniques too I guess...
> From: Terry J DuBose <tjdubose@juno.com>
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