The Value Of Conventional Ultrasound And Ultrasound Elastography In Diagnosis Of Breast Solid Nodules

Objective1.To study the diagnostic value of conventional ultrasound in benign and malignant breast solid nodules identification.2.To study the diagnostic value of ultrasound elastography in benign and malignant breast solid nodules identification, which includes the scoreing method of ultrasound elastography and measuring the strain ratio between breast nodule and the same level glandular tissue with nodule.3.To study the diagnostic value in benign and malignant breast solid nodules identification through conventional ultrasound combined with elastography score.4.To compare the diagnostic value of above four methods of identification of benign and malignant solid nodules of the breast.Materials and Method105female patients with131breast solid nodules were examined during October2011to March2012in Heping hospital of Changzhi medical college, including outpatient and inpatient treatment. The typical cystic masses and the cystic--based mixed tumors were not included. All solid nodules were removed by surgeons and were done histopathological examination. The age range is from15years old to83years old. The average age is45.3±10.5years. The instrument was HITACHI Erlangshen ultrasonic diagnostic apparatus and the probe frequency was from6MHz to13HMz. Patients were firstly examined by using conventional ultrasound. Secondly, they were examined by using ultrasound elastography technology. All solid nodules were conducted UE score and measured their strain ratio. The SPSS19.0were used to analyze the date. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of four methods were calculated. The chi--square test was used to observed if the difference of various methods was statistically significant. The receiver operating characteristic curve was drawed in order to obtain the best diagnostic threshold values of the strain rate ratio of the solid nodules of benign and malignant and to study diagnostic accuracy of every method according to AUC.Results1.The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of evaluation of benign and malignant solid nodules by using conventional ultrasound were89.31%、80.56%、92.63%、80.56%.92.63%.2.The elasticity mark≥4was defined malignancy. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of evaluation of benign and malignant solid nodules by using the ultrasonic elastography scoreing method were83.97%7、5.00%、87.37%、69.23%、90.22%。3. The best diagnostic critical threshold of the strain ratio of the solid nodules of benign and malignant was3.12. SR≥3.12was defined malignancy. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of evaluation of benign and malignant solid nodules by measuring the strain ratio were84.73%、80.56%、86.31%、69.05%、92.13%。4.The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of evaluation of benign and malignant solid nodules by using conventional ultrasound combined with ultrasonic elastography score were87.02%、97.22%、83.16%、68.62%98.75%。5.The data of AUC by using conventional ultrasound, elastography score,strain ratio, conventional ultrasound combined with elastography score were0.868,0.744,0.806,0.837respectively, which were between0.7--0.9. The range of above four methods can tell the diagnostic accuracy in indentifying benign and malignant solid nodules.6. The difference of accuracy、sensitivity、specificity of pairwise of four methods was compared. The sensitivity of conventional ultrasound combined with elastography score was higher than the other of each method and their difference was statistically significant(P<0.05). The specificity of conventional ultrasound was higher than conventional ultrasound combined with elastography score and their difference was statistically significant(P<0.05). Conclusions1. Using conventional ultrasound, ultrasound elastography score, the Strain Ratio of elastography conventional ultrasound combined with elastography score to identify benign and malignant solid nodules of the breast all have a certain diagnostic value. But it was no statistically significant between the application of ultrasound elastography technology and application of conventional ultrasound in the differential diagnosis of breast solid nodules of benign and malignant.2. Conventional ultrasound combined with ultrasound elastography score can improve the diagnostic sensitivity of malignant nodules and early breast cancer detection rates and can possibly realize the early detection, early diagnosis, early treatment. Ultrasound elastography is a useful complement to conventional ultrasound diagnostic.