| Objective:To investigate diagnosis value of ultrasonic elastography (UE) for evaluating breast lesions, improve ultrasound diagnostic level of differentiating benign breast lesions from malignant ones.Methods:The study involving female patients, who treated in the department of gastric glands surgery guangxi medical university affiliated hospital during May2010to June2011. The study including116patients with complete data, the study with150breast lesions.All the patients did not accept chemotherapy and radiation therapy, but accepted ultrasound examination. Each breast lesion diameter was less than5.0cm, confirmed by postoperative pathology results. All the breast lesions were on the conventional sonography, UE check and MRI.Two-dimensional ultrasonic scoring(2D-US) images were estimated based on the Breast Imaging Recording and Data System (BI-RADS) classification formulated by American College of Radiology(ACR), Color Doppler Flow Imaging(CDFI) were evaluated by reference Alder standard, and UE images were based on the improved5-scoring system. Histopathology was used as the golden reference standard, ultrasonic was used to evaluate differential diagnosis of benign breast lesions from malignant ones.Results:1. The future of the breast lesions by conventional sonography, the malignant lesions with irregular form, the long axis were not parallel to the skin, incomplete edge, asymmetry internal echoes, posterior acoustic attenuation, interior with micro calcification, internal blood flowed to the rich, Pulsed-wave Doppler(PW) showed Resistance Index(RI) were greater than0.7. The differences were statistically significant (P<0.05). The ratio of benign breast lesions with clear borders and posterior acoustic enhancement were a little bit higher, but the difference was not statistically significant (P>0.05).2. It was127breast lesions were checked with UE for correct diagnosis,but only23breast lesions were for mistake diagnosis. The UE score of the malignant lesions were high,and the benign lesions were low. All the benign breast lesions diagnosed by pathology, UE score for1to3points accounted for69.0%of the total. All the malignant breast lesions diagnosed by pathology, UE score for4-5points accounted for98.7%of the total. UE score in3and4points were misdiagnosed easily. The number of breast lesions smaller than2.0cm was65,and the accuracy of UE was86.7percent. The number of breast lesions greater than2.0cm was62, and the accuracy of UE was82.7percent.3. The accuracy of2D-US,CDFI and UE was79.3percent,78percent and84.7percent respectively. Comprehensive consideration of the three methods, the accuracy of the ultrasound was85.3percent. The accuracy of UE was higher than that of conventional ultrasound(P<0.05). The accuracy of ultrasound combined conventional ultrasound and UE was significantly better than that of conventional ultrasound only (P<0.05).Conclusions:1.The conventional ultrasonic characteristics of the malignant breast lesions were with irregular shape, the orientation of the lesions were not parallel to the skin, incomplete edge, nonuniform internal echoes, micro calcification,shadowing posterior acoustic feature, the rich blood, resistance index were equal or greater than0.7.2. UE was an important method of differentiating benign and malignant breast lesions. The UE score of the malignant lesions was high, and the UE of the benign lesions was low.3. UE score in3and4points were misdiagnosed easily. UE combined with conventional ultrasound improved breast lesions diagnosis accuracy better. |
