Diagnostic Value Of Ultrasonic Strain Elastography In Different Pathological Types Of Mastitis Lesions

ObjectiveTo evaluate the value of Strain elastograph(SE)in differential diagnosis of different pathological types of breast inflammatory lesions.MethodsA total of 154 suspected mastitis patients who received(Color doppler u Itrasonography,CDU)and SE examinations in the First Affiliated Hospital of Jinzhou Medical University and Liaoyang Central Hospital from June 2019 to June 2022 were retrospectively collected.The ultrasound-guided puncture biopsy results were used as the gold standard.A total of 128 cases were enrolled according to the inclusion and exclusion criteria.CDU and SE imaging data of patients were collected for statistical description.Pathological results were used as the gold standard to analyze and compare the diagnostic efficacy(accuracy,sensitivity,specificity,positive predictive value and negative predictive value)of SE and CDU for mastitis lesions.ResultsThere were 128 cases of mastitis confirmed by pathology,and the main pathological types were 1)plasmacytic mastitis in 71 cases,which showed a large number of infiltration of plasma cells,lymphocytes and foam cells.2)42cases of granulomatous mastitis were presented as lobule-centered granulomatous inflammation,the lesions were significant in the lobule of the breast,the number of small acinus in the lobule was significantly reduced to disappear,and the infiltration of lymphocytes was mainly accompanied by neutrophils,eosinophils and plasma cells.3)There were 2 cases of breast tuberculosis,and the distribution of granuloma was often irregular.Unlike granulomatous mastitis,the distribution of lesions was characterized by breast lobules as the center,often caseous necrosis,and neutrophils and small vesicles were rare.4)13 cases of suppurative mastitis showed a large number of neutrophil infiltration.1.Diagnostic results of CDU for breast inflammatory lesions of different pathological typesWith ultrasound-guided puncture biopsy as the gold standard,the total accuracy of CDU for the diagnosis of different types of mastitis was 82.03 %(105/128).2.SE diagnosis results of different pathological types of breast inflammatory lesionsWith ultrasound-guided puncture biopsy as the gold standard,the overall accuracy rate of SE detection for different types of mastitis was 90.63%(116/128).3.Comparison of the diagnostic efficacy of SE and CDU for breast inflammatory lesionsThe overall accuracy of SE detection was higher than that of CDU detection(P= 0.017).For both plasmacytic mastitis and granulation mastitis,SE had higher accuracy than CDU(Plasmacytic mastitis 91.41% vs 83.59%;Granulomatous mastitis 91.41% vs 84.38%)and sensitivity(Plasmacytic mastitis 94.12% vs 86.76%;Granulation mastitis 86.05% vs 73.91%).For breast tuberculosis and suppurative mastitis,there was no significant difference in the diagnostic efficacy of CDU and SE(P > 0.05).Conclusions1.The overall accuracy of SE test for different types of mastitis was higher than that of CDU test.2.For the two types of mastitis,plasma cell mastitis and granulomatous mastitis,SE detection technique has higher accuracy and sensitivity than CDU.3.SE and CDU examination techniques have high application value in the diagnosis of mastitis lesions of different pathological types.Can provide reliable theoretical basis for clinical diagnosis and help for symptomatic treatment of various mastitis.