| Objective:To investigate the value of conventional ultrasound combined with ultrasound elastography(UE)in the differential diagnosis of small benign and malignant breast solid nodules.Materials and methods:80 patients with 91 small(less than 2.0 cm in diameter)breast solid nodules from September 2015 to March 2017 in No.88 Hospital of Chinese People’s Liberation Army were included in this study.Pathological results of nodules were obtained from through surgery or ultrasound-guided core needle biopsy.After preoperatively conventional ultrasonography,UE mode was activated.The strain ratio(SR)and area ratio(AR)were measured by the measurement software,and images were stored.The pathological results were used as diagnostic criteria,and the data were analyzed by SPSS 19.0 software.Using the specificity as the abscissa and the sensitivity as the ordinate,the working characteristic curve of the receiver(ROC)was drawn.The best cutoff values of strain ratio and area ratio were obtained.Comparison between pathological results and the conventional ultrasound,SR,AR,conventional ultrasound combined with SR,respectively,was made.The specificities,sensitivities,accuracies,positive predictive values,negative predictive values,misdiagnosis rates,missed diagnosis rates of four methods were calculated,and two-two comparisons were done by the chi square test.The diagnostic capacities of these four methods were compared by calculating the areas under the ROC curves.Result:Among 91 small breast solid nodules,37 nodules were benign,including 10 breast adenosis,24 breast fibroadenomas,1 intraductal papilloma,1 chronic inflammation and 1 hyperplastic nodules.There were 54 malignant nodules,including 50 infiltration ductal carcinomas,2 infiltration lobular carcinomas,1 mixed type mucinous carcinoma and 1 medullary carcinoma.1.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of conventional ultrasound for evaluating solid small nodules in the breast was 88.9%、75.7%、83.5%、 84.2%、82.3%,respectively.2.With the highest Youden index as the standard,to determine the optimal cutoff value of strain ratio was 3.88,more than 3.88 for the diagnosis of malignant and benign diagnosis is less than 3.88,the specific on the sensitivity and differential diagnosis of solid breast nodules in benign and malignant degree,accuracy and positive predictive value,negative predictive value was 84.6%、 74.3%、 81.5%、78.4%、 80.2%,respectively.3.With the highest Youden index as the standard,to determine the optimal cutoff area ratio method was 1.1,more than 1.1 for the evaluation of malignant and benign evaluation is less than 1.1,the specific on the sensitivity and differential diagnosis of solid breast nodules in benign and malignant degree,accuracy and positive predictive value,negative predictive value was 79.6%,70.3%、75.8%、 79.6%、 66.7%,respectively.4.The sensitivity,specificity,accuracy and positive predictive value of differential diagnosis of benign and malignant breast nodules were 92.6%、 81.1%、 87.9%、87.7% and 88.2%,respectively,by conventional ultrasound combined with strain rate ratio method.5.Conventional ultrasound,strain ratio and area ratio method,the sensitivity of the four methods of conventional ultrasound combined with strain ratio method the specificity and accuracy of compared with that of conventional ultrasound combined with sensitivity of strain ratio and accuracy are higher than that of conventional ultrasound and strain ratio method,and the difference was not statistically significant different(P>0.05).6.The area under the curve of the four methods was 0.823、0.837、0.815、0.841.Conclusions1.The values of conventional ultrasound,SR,AR and conventional ultrasound combined with SR in the differential diagnosis of small benign and malignant breast solid nodules were all higher.2.Compared with the conventional ultrasound,SR and AR,the sensitivity,specificity and accuracy of conventional ultrasound combined with SR were improved. |
PDF Full Text Request