Coded harmonics in breast ultrasound: Does it make a difference?

With the improvement of spatial and contrast resolution in breast sonography, several new interpretive difficulties have arisen. Cysts that appeared to be simple on older equipment may now contain internal echoes with newer high-resolution equipment. Historically, teaching has stressed the presence of internal echoes as indicative of a complex cyst, often requiring further evaluation. However, many of the internal echoes seen with higher frequency, broadband, and greater dynamic range equipment are artifactual. In this study, breast cysts, solid lesions, and normal structures were evaluated comparing fundamental to coded harmonic imaging to determine if coded harmonics can help distinguish artifactual from real internal echoes.