The Value Of Ultrasound Elastography Combined With BI-RADS Classification In The Diagnosis Of Benign And Malignant Breast Nodules

Objective:To explore the diagnostic value of ultrasound elastography evaluation methods combined with breast imaging reporting and date system(BI-RADS)classification in the differential diagnosis of benign and malignant breast nodules,so as to provide reference for the early detection of breast cancer.Methods: Patients with breast nodules diagnosed by ultrasound from August 2020 to December 2021 were selected from the People’s Hospital of Juye County,Shandong Province.The breast nodules were classified by BI-RADS using conventional ultrasound.All selected lesions were scored by elastography score(SE)and measured by strain rate ratio(SR).Ultrasound elastography combined with BI-RADS classification was used for joint diagnosis.All selected cases were performed puncture biopsy or surgical resection and histopathological examination to determine the benign and malignant breast nodules.The clinical value of simple BI-RADS classification,ultrasonic elastography and ultrasonic elastography combined with BI-RADS classification diagnosis was evaluated by comparing the results of pathological examination.The receiver operating characteristic curve(ROC)was used to compare the sensitivity,specificity,accuracy and area under the ROC curve of different examination methods,and to compare whether the difference between different examination methods was statistically significant.Results:(1)A total of 129 patients were enrolled in this study,including 129 breast nodules,48 malignant breast nodules and 81 benign breast nodules confirmed by pathology.Among the 81 benign breast nodules,there are 31 breast adenosis,19 breast fibroadenoma,9 breast cystic hyperplasia,7 breast benign phyllodes tumor,7 breast intraductal papilloma,and 8 serous mastitis.Among the 48 malignant breast nodules,there are 21 invasive ductal carcinoma,12 intraductal carcinoma in situ,8 invasive lobular carcinoma,4 lobular carcinoma in situ and 3 intraductal papillary carcinoma.(2)The sensitivity,specificity,accuracy and area under the ROC curve of conventional ultrasound BI-RADS classification for evaluating benign and malignant breast nodules were 91.4%,81.2%,89.2% and 0.863.The accuracy of ultrasound elastic score in the diagnosis of benign and malignant breast nodules was 87.7%,83.3%,89.9% and 0.855 respectively.The sensitivity,specificity,accuracy and area under the ROC curve of ultrasound elastic strain rate ratio method in the diagnosis of benign and malignant breast nodules were 84.0%,79.2%,87.2% and 0.816,respectively.(3)The sensitivity,specificity,accuracy and area under the ROC curve of the combined diagnostic method of ultrasonic elastography combined with BI-RADS classification were 95.1%,92.7%,96.3% and0.944 respectively.Compared with the simple BI-RADS classification and ultrasonic elastography,the sensitivity,specificity,accuracy and area under the ROC curve of the combined diagnostic method of ultrasonic elastography combined with BI-RADS classification were superior to the simple BI-RADS classification and ultrasonic elastography(P<0.05).Conclusion : Ultrasound elastography combined with BI-RADS classification has not only high sensitivity but also high accuracy for the diagnosis of benign and malignant breast nodules.It has good clinical diagnostic value for the diagnosis of breast nodules and can provide reference for the timely diagnosis of breast cancer.