Evaluation of male gynecomastia with B-mode and color Doppler ultrasound

Purpose: To analyze the presence and type of vascularity with CDUS in gynecomastia and to compare these CDUS findings with the characteristic US appearances of Tanner stages.

Methods and materials: A total of 108 breasts of 54 males aged 11–27 years presenting with a complaint of gynecomastia and with US verification of gynecomastia were evaluated. The retroareolar thickness was measured. Then US finding were staged according to the Tanner classification. The breast was divided into three quadrants as lateral, medial and areolar and arterial blood flow was determined using CDUS. Venous blood flow was classified according to the number of blood vessels in each breast. The statistical methods used Spearman's rho comparison test.

Results: Gynecomastia was present in 78 breasts (30 unilateral, 24 bilateral) with a retroareolar thickness of 5–31mm (median 20) and a symptom duration of 1–300 weeks (median 10). Fifteen breast with gynecomastia had no arterial flow or venous vessels. The Tanner stages were found to be strongly associated with numbers of quadrant of arterial flow(r=0.78), numbers of venous vessels (r=0.62), duration of symptoms (r=0.8) and retroareolar thickness(r=0.78). All of these correlations were statistically significant (p=0.00).

Conclusion: The diagnosis and staging of gynecomastia on B-mode US is done according to the ductus, and adipose and fibrous tissue content. This study shows that vascular structures have to be accepted as a component of gynecomastia.Adding CDUS to B-mode US findings should therefore make it possible to use sonography with more objective criteria for the sonographic staging of gynecomastia.