The Breast Ultrasound Types Combined With Ultrasound Elastography (UE) In The Diagnosis Of BI-RADS 4 Lesions

Part I Correlation of the breast ultrasound types with diagnosis of benign and malignant breast tumorsObjective:Ultrasound is used to division the background of the mammary gland,to analysis the correlation between the breast ultrasound types and benign and malignant breast masses.Methods:197 patients with 201 breast lesionswereconfirmed by pathology,including 41malignant lesions and 160 benign ones.According to the breast ultrasound types,the ultrasound images were categorized into 3 types,including glandular type,glandular fiber type and fatty type.The correlation of the breast ultrasound types and benign and malignant breast masses was tested byc~2test.Results:There was no significant difference in the distribution of benign and malignant lesions between the glandular type and glandular fiber type on the background of breast(P=0.204),between the ultrasound background of glandular type and the type of fat,glandular fiber,and type of fat.The difference between benign and malignant lesions was statistically significant(P<0.001).Conclusion:The breast ultrasound types of female mammary gland have certain correlation with breast cancer,of which the fat-type breast is one of the risk factors for breast cancer.Part II The Breast Ultrasound Types Combined with Ultrasound Elastography(UE)in the Diagnosis of BI-RADS 4 LesionsObjective:To investigate the value of breast imaging reporting and data system(BI-RADS)combined with the breast ultrasound types together with ultrasound elastography(UE)in the diagnosis of BI-RADS 4 breast lesions.Methods:85 patients with 102 breast lesionswereanalyzed and classified by BI-RADS for BI-RADS 4,to correct classification based on the breast ultrasound typesandthe score of UE.Then draw ROC curve to compare the diagnostic efficiency in breast lesions by using BI-RADS and using BI-RADS combined with the breast ultrasound typesand UE.Results:In the 102 lesions,66 lesions were benign and 36 lesions were malignant.The sensitivity of BI-RADSand BI-RADS+the breast ultrasound types+UEin the diagnosis of breast cancer was 77.8% and 91.7%.The specificity of them was 62.1% and90.9%.The accuracy of them was 68.0% and 91.2%.The positive predictive value of them was 52.8% and 84.6%.The negative predictive value of them was 83.7% and95.2%.AUC of them was 0.699 and 0.899.In the diagnosis of breast cancer,the specificity and accuracy of BI-RADS+the breast ultrasound types+UE were significantly higher than those of BI-RADS classification(P<0.001,P=0.0287),the difference in AUC is statistically significant(P<0.05).Conclusion:The methods of BI-RADS+the breast ultrasound types+UE can significantly improve the value of ultrasound in the diagnosis of BI-RADS 4 breast lesions.