The Value Of Ultrasound Elastography Area Ratio, Ultrasound Elastography Scoring And BI-RADS In The Differential Diagnosis Of Benign And Malignant Breast Lesions

Objective: 1. To evaluate judgment of differentiate diagnosis in benign and malignant breast tumors in ultrasound elastography area ratio, where taking pathology results as the gold standard. Constructed the ROC curve and the area under the curve was calculated in order to determine the value of clinical diagnostic, the best diagnostic point was obtained and another valid standard was provided in order to improve the identification of benign and malignant breast masses ability.2. The clinical value in differential diagnosis of benign and malignant breast lesions with BI-RADS, ultrasound hardness scoring and ultrasound elastography area ratio were compared, the advantages and limitations were analyzed, and a more reasonable evaluation method was expected to find. Methods: A total of 130 lesions including 152 patients underwent ultrasound two-dimensional and elastography ultrasound, leveled by BI-RADS and scoring with improved-5 scoring system after obtaining satisfactory images. The area in the ultrasound elastographic images and two-dimensional images of breast lesions were measured and the ratio between them was calculated. The ROC curve was constructed by the pathologic result as gold standard, and obtaining the best diagnostic point of elastography area ratio in differential diagnosis of breast lesions as the same time. This point was compared with BI-RADS score and ultrasound hardness score in sensitivity, specificity and accuracy respects for the value of diagnosis of breast lesions. Results: 1.The ROC curve was constructed by the probability forecasting of ultrasound elastograph area ratio, the area under it was 0.852. The sensitivity, specificity and accuracy were 78.05%, 85.71%, 81.58% when the diagnostic point of area ratio was 1.34, and malignant breast nodules area ratio was significantly higher than in benign nodules.2. The sensitivity, specificity and accuracy were 90.24%, 91.43%, 90.79% of ultrasound elastography scoring system in the diagnosis of benign and malignant breast tumors.3. The sensitivity, specificity and accuracy were 82.93%, 82.86%, 82.89% of BI-RADS scoring system in the diagnosis of benign and malignant breast tumors.4. The sensitivity, specificity and accuracy in BI-RADS, ultrasound elastography scoring and ultrasound elastography area ratio were compared. The conclusion showed that there was statistical significance in accuracy difference and sensitivity difference with ultrasound elastography scoring and ultrasound elastograph area ratio(P<0.05), and in accuracy difference with BI-RADS and ultrasound elastography scoring(P<0.05). Conclusion: 1. The ultrasound elastography area ratio can indirectly reflect the size of the breast lumps and surrounding tissue involvement. The clinical value was better when the diagnostic point of area ratio was 1.34.2. The ultrasound elastography scoring was better than the ultrasound elastograph area ratio and BI-RADS in accuracy. The ultrasound elastography scoring was better than the ultrasound elastograph area ratio in sensitivity.3. The combination in clinical practice of BI-RADS, ultrasound elastography, elastography area ratio can complement and refer each other.