Value Of Elastography Combined With Multimode Ultrasound In The Diagnosis Of Granulomatous Mastitis

Objective:1.To compare the advantages and disadvantages of elastography and multimode ultrasound in the diagnosis of granulomatous mastitis.2.To evaluate the application value of four methods: multi-mode ultrasound,elastic imaging score,elastic strain rate ratio,ultrasound elastic score combined with multi-mode ultrasound in granulomatous mastitis(GM).Methods:A retrospective study was conducted on 42 patients with granulomatous mastitis who underwent ultrasound Elastograpy(UE)and multimode ultrasound from November 2015 to December 2018.They were confirmed by pathology by hollow needle aspiration biopsy or operation.They were all women of childbearing age,ranging from 22 to 52 years old,with an average age of 30.7 years.Multimodal ultrasound and elastography images of all cases were collected.Breast Imaging Reporting and Data System(BI-RADS)was used to evaluate the nature of the lesion.The lesions were classified as BI-RADS 2,BI-RADS 3 and BI-RADS 4A,which were consistent with the pathological results.The lesions were classified as BI-RADS 4B,BI-RADS 4C and BI-RADS 5,which were inconsistent with the pathological results.The elastogram was scored and the strain ratios(SR)were measured.The benign lesions were scored 1-3 points and the strain rates < 3.08,which were consistent with the pathological results.The malignant lesions were scored 4-5 points and the strain rates(> 3.08),which were inconsistent with the pathological results.The coincidence rate between classification and pathological results was evaluated in four groups: multimodal ultrasound group A;elastic imaging score group B;elastic strain rate ratio group C;elastic imaging score combined with multimodal ultrasound group D.Results:The diagnostic coincidence rates of group A,group B,group C,elastic strain rate ratio and group D were 76.19%,83.33%,90.47% and 97.61% respectively.The diagnostic coincidence rates of group C were higher than those of group B,group B and group C were higher than those of group A,but there was no significant difference between the two groups(P>0.05).Comparing the diagnostic coincidence rates of group A,B and C with group D,there was significant difference between group A and group D,P<0.01;there was significant difference between group B and group D,P<0.05;there was no significant difference between group A and group B,group A and group C,group C and group D,P>0.05.Conclusions:1.Multimodal ultrasound,elastic imaging score,elastic strain rate ratio,elastic imaging score combined with multimodal ultrasound have certain value in the diagnosis of granulomatous mastitis lesions.2.UE has high clinical value in the diagnosis of GM,especially in the differential diagnosis between early GM small lesions and malignant small nodules.3.The diagnostic value,classification and pathological coincidence rate of UE combined with multi-mode ultrasound for GM were higher than those of single method.Combination of four methods can improve the coincidence rate of GM diagnosis.