BI-RADS: Ultrasound Update Including Elastography. Where Do We Stand Now?

  • Alexander Mundinger


New developments in ultrasound (US) encompass 3D automated US as an adjunct to screening, handheld highfrequency transducers in whole breast US, and hybrid systems. High-frequency US is relevant for assessing small mammographic masses and for preoperative staging to detect accompanying focal or ductal changes due to ductal carcinoma in situ (DCIS) and metastatic axillary lymph nodes (ALN). Advanced modes such as compounding, tissue harmonic imaging (THI), and speckle reduction increase the signal to contrast ratio. Doppler techniques and elastography are additional tools to recategorize Breast Imaging Reporting and Data System (BI-RADS) 3 vs. 4a lesions, suggesting upgrading the former if the lesion is stiff or hypervascularized and downgrading the latter if the lesion is soft and not vascularized. Modern US assessment of architecture, flow, elasticity, and redefinition of special cases are among the highlights of the updated BI-RADS lexicon. The most relevant descriptors for characterizing a US lesion continue to comprehend shape, margin, and orientation together.


Sentinel Lymph Node Biopsy Strain Elastography Terminal Duct Lobular Unit Tissue Harmonic Imaging Complicated Cyst 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  • Alexander Mundinger
    • 1
  1. 1.Radiological Department and Breast CentreNiels-Stensen-ClinicsOsnabrueckGermany

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