Diagnostic Value Of Shear Wave Elastography In The Differentiation Of Benign And Malignant Soft Tissue Tumors

Objective:To explore the value of shear wave elastography(SWE)in differentiating benign from malignant soft tissue tumor(STT),and to provide an important means for the early diagnosis of benign and malignant soft tissue tumor.Methods:1.A total of 87 patients diagnosed with soft tissue tumor in the First Affiliated Hospital of Nanchang University from November 2019 to October 2020,were selected as study subjects,record the patient’s general condition,such as gender,age,height,weight,All patients were divided into benign group and malignant group according to pathological results,The malignant group was subdivided into sarcoma group and metastatic group according to pathological classification.2.All patients were performed conventional ultrasound and elastic shear wave imaging.The relaxed position exposed to the lesion was selected,and gray scale ultrasound was performed first to observe the location,internal echo,boundary,morphology and the relationship between the mass and the surrounding tissues,and the maximum diameter line of the mass was measured.Then using color doppler for lesions internal and peripheral blood flow distribution,and then switch SWE mode to obtain the measured depth of the mass and measure mass of maximum value of elasticity(Emax).mean value of elasticity(Emean).minimum value of elasticity(Emin).3.Compare the differences between benign and malignant group and malignant groups are statistically significant,and draw the receiver-operating characteristic curve(receiver operator characteristic,ROC),calculate the Area under the ROC curve(Area under the curve,AUC),To obtain the cutoff value,accuracy,sensitivity and specificity,positive predictive value and negative predictive value of differential diagnosis of benign and malignant soft tissue tumors.Results:1.Pathology results: a total of 87 lesions,of which 35 cases of malignant lesions,including 6 cases of fibrosarcoma,6 cases of malignant melanoma,5 cases of undifferentiated sarcoma,4 cases of lymphoma,2 cases of synovial sarcoma,3 cases of metastatic carcinoma,3 cases of rhabdomyosarcoma,2 cases of fat sarcoma,2 cases of leiomyosarcoma,1 cases of osteosarcoma,1 cases of mucous chondrosarcoma;There were 52 benign lesions,including 8 cases of hemangioma,10 cases of lipoma,13 cases of schwannoma,9 cases of neurofibroma,6 cases of giant cell tumor of tendon sheath,5 cases of inflammatory mass,and 1 cases of nodular fasciitis.2.There were 28 males and 24 females in the benign group,with an average age of 42.37±14.51 years old.There were 18 males and 17 females in the malignant group,with an average age of 48.03±13.75 years old.The body mass index(BMI)of the benign and malignant groups was 22.66±2.13 and 22.41±1.80,respectively.There were no significant differences in age,sex ratio and BMI between benign group and malignant group(all P >0.05),the measurement depth of benign and malignant groups was 1.73±0.65 cm and 1.84±0.93 cm,respectively,and there was no statistical significance in the measurement depth between benign and malignant groups(P>0.05).The maximum diameter of benign lesions in soft tissue tumors was4.10±1.24 cm,and that of malignant lesions was 4.94±1.41 cm.The difference in the maximum diameter of benign and malignant tumors was statistically significant,and the malignant group was greater than the benign group(P <0.05).The difference of blood flow distribution between benign and malignant groups was statistically significant(P <0.05),but there was no statistically significant difference in internal echo,clear boundary and uniform echo.(P >0.05).3.SWE results:The Emax,Eean,and Emin of benign lesions were 75.92±26.53 kPa,50.44±22.20 kPa,33.52±18.03 kPa,respectively.The Emax,Eean,and Emin of malignant lesions were 107.77±33.50 kPa,72.03±26.64 kPa,and39.51±17.97 kPa,respectively.The differences were statistically significant(t=-4.93,-4.10,all P <0.05).There was no statistically significant difference in Emin between benign and malignant groups(t=-1.52,P<0.05),and there was no statistically significant difference in Emax,Emean,and Emin among different pathological types(sarcoma group and Other malignancies)in malignant group(P>0.05).4.ROC curve analysis: with the pathological results as the gold standard,draw the ROC curve,according to Emax = 103.5 kPa,Emean = 66 kPa for the diagnosis of benign and malignant soft tissue tumor of cutoff value,the area under the ROC curve(AUC)were 0.764,0.740,diagnostic accuracy,sensitivity,specific,positive predictive value,negative predictive value were 79.3%,71.4%,84.6%,75.8%,81.5%,74.7%,68.6%,78.8%,68.6%,78.8%.Conclusion:1.Shear wave elastography can effectively and noninvasively evaluate the elastic information of soft tissue tumors,effectively improve the diagnostic efficiency of conventional ultrasound,and has a certain value for the differentiation of benign and malignant soft tissue tumors.2.When the Young’s modulus value Emax= 103.5kPa was used as the cutoff value for differentiating benign and malignant soft tissue tumors,its accuracy,sensitivity,specificity,positive predictive value and negative predictive value were all higher than that of Emean.