Diagnostic Value Of Multimodal Ultrasound And Its Combined Scoring Method For Non-lump Type Lesions Of The Breast

Objective: To study and analyze the diagnostic value of multimodal ultrasonic combined scoring(BCST scoring)in non-lump type lesions of the breast.Method: The object of this study is a female breast disease who was diagnosed and treated in our hospital in September 2014 ~2017 September.The age is over 1 years old.After regular ultrasound examination is found as a non mass lesion,all the patients were examined by conventional ultrasound BI-RADS(Breast Imaging-Reporting and Data System)classification,contrast-enhanced ultrasound(CEUS)and shear wave elastography(SWE),and three-dimensional ultrasound ultrasonography(3DUS),then all the patients according to multimodal ultrasound(ultrasound + ultrasound + + 3D ultrasound shear wave elastography imaging)comprehensive diagnostic test results,using multi mode ultrasound combined scoring method(this study referred to as the BCST score,BI-RADS-CEUS-SWE-3DUS)as the evaluation of non swollen A type of benign and malignant lesions(4 standard ultrasound scoring method respectively each inspection method,a total of 3 points,four methods of inspection score added more than 8 total points,this study considered asmalignant,< 8,considered as benign).Follow-up these patients,115 patients with complete pathological data were collected,and the results of ultrasound diagnosis were compared with the pathological results of the patients(puncture or postoperative pathology).The SPSS23.0 statistical software was used to analyze the data,the count data was expressed by%,and the x 2 test was used as the gold standard for the pathological condition.Results: 115 cases of non-lump type lesions of the breast were diagnosed as malignant in 42 cases and benign in 73 cases by pathological diagnosis.The characteristics of ultrasound were compared: the growth pattern,shape,internal echo,blood flow distribution,calcification,elasticity modulus and contrast enhancement mode were statistically significant(P<0.05).Single ultrasound diagnosis results are as follows:(1)The sensitivity of conventional ultrasound evaluation of breast non mass lesions was 62.1%,the specificity was 56.1%,the diagnostic coincidence rate was 58.2%;(2)the sensitivity of ultrasonography in the diagnosis of breast non mass lesions was 75%,the specificity was 77%,the diagnostic coincidence rate was 75.6%;(3)the sensitivity of non mass lesions the wave breast elastography to determine the shear was 74.4%,the specificity was 72.6%,the diagnostic coincidence rate was 73%;(4)the sensitivity of three dimensional ultrasonography in diagnosis of breast non mass lesions was71.4%,the specificity was 73.9%,the diagnostic coincidence rate was 73%.The diagnostic results of multimodal ultrasound combined scoring system(BCST score): the sensitivity of BCST in diagnosing breast non mass lesions is88.1%,the specificity is 91.7%,and the diagnostic coincidence rate is 90.4%.The results indicated that:(1)In the ultrasonic diagnosis of breast non mass lesions in the diagnostic performance of contrast-enhanced ultrasound,shear wave elastography and three-dimensional ultrasound were higher than that of the conventional ultrasonic BI-RADS classification method,but is still not ideal;(2)The BCST score method can significantly improve the diagnostic efficiency of breast non mass lesions.The sensitivity,specificity and diagnostic coincidence rate were higher than those of the 4 methods,and the difference was statistically significant(P<0.05).Conclusion:(1)Conventional ultrasound,ultrasound contrast,shear wave elastic imaging and three-dimensional ultrasound have certain diagnostic value in non-lump type lesions of the breast.(2)The multimodal ultrasonic combined scoring method is superior to the single diagnostic method.It has high sensitivity,specificity and diagnostic coincidence rate.It is worthy of clinical application.