Compared The Diagnostic Value Of Strain Ratio To5Scoring System With Ultrasound Elastography In The Diagnosis Of Breast Tumors

Materials and methods1. PatientsClinical data were collected in breast surgery clinic in Shandong province QianfoMountain hospital from December2010to June2011,all that were operated.There were atotal of103breast tumors of89cases of breast cancer patients.The patients all werefemale.Age:22-81years old. The average age is52years old.All cases were confirmed byoperation and pathology.There were71malignant tumors, including53invasive cathetercancer,7ductal carcinoma,3infiltrating lobular carcinoma,7invasive tubular carcinoma,1mucinous carcinoma.There were32benign tumors, including27fibroadenomas,4intraductal papilloma, mammary duct ectasia with hyperplasia of mammary gland,1cystformation.The maximum diameter was9.5cm, the smallestdiameter was0.8cm.2. MethodsWith TOSHIBA AplioXG and GE LOGIQ E9color Doppler diagnostic instrument,and the frequency is6~13MHz. First,we detect the tumor with conventional method.Check the location, size, hardness and activity of breast tumor, focusing on the tumorlocation, size, shape, boundary, internal echo envelope, and check that if there iscalcification, rear echo, then observe ultrasound blood flow signals in the tumor and thesurrounding by color Doppler, and then switch to elasticity imaging mode, to determine theelastic graph sampling frame (region of interest ROI), to select2times size of massrange, hand-held probe in the position of the mass,and then make small, medium speedvibration, the control apparatus for display on a pressure and compression frequency indexin3then froze the map.The probe always perpendicular to the plane in entire process, withtwo real time display function, observe the two-dimensional and elastic graph, the graphoutline mass in the region and with the level of normal breast tissue in the glandular tissue,using ultrasonic apparatus for measuring method, elastic strain ratio (SR) measuring, the same tumor by two kinds of machines are equipped with elastic imaging software toundertake an analysis, use TOSHIBA AplioXG with elasticity imaging software analysis ofbreast tumor with the same level Normal mammary glands of the strain rate ratio (srtainratio, SR), the study of SR by local strain rate ratio method, the critical value of31.15SRis greater than the critical value, the mass was diagnosed as malignant, SR is less than thecritical value of the mass was diagnosed as a benign; GE LOGIQ E9with elasticity imaginganalysis software with a mass in the same the regional elasticity measured values, with5points, score greater than3for the diagnosis of malignant, score less than3for the diagnosisof benign.3.Statistical analysisApplication of SPSS13.0statistical software packages for data analysis, in order topathological diagnosis as the gold standard, elastography strain ratio and5points method inthe diagnosis of breast lesions using ASD2test value. With P <0.05for the difference wasstatistically significant.Results1.There are63tumors in71malignant tumors whose SR≥31.15，accouting for88.7%, and there are8in71malignant tumors whose SR <31.15, accouting for11.3%.There are15tumors in31benign tumors whose SR<31.15,accouting for90.6%, andThere are3tumors in31benign tumors whose SR≥31.15accouting for9.4%. The ratio ofmalignant tumors larger than31.15was significantly higher than that in benign tumors,there was significant difference between the two.2.With5points method in the measurement of the value of elasticity imaging: Thereare62tumors in71malignant tumors whose point≥3, accouting for87.3%.There are9tumors in71malignant tumors whose point<3, accouting for12.7%. There are27tumorsin32benign tumors whose point<3,accouting for84.3%, There are5tumors in32benign tumors whose point≥3,accouting for15.7%. The ratio of Malignant tumors whosepoint≥3was significantly higher than that in benign tumors, there was significantdifference between the two.3.The accuracy, sensitivity, specificity of using strain rate ratio method in thediagnosis of benign and malignant breast tumors were respectively89.3%,88.7%,90.6%.The accuracy, sensitivity, specificity of5points method in diagnosis of breast benign andmalignant tumors were respectively86.4%,87.3%,84.4%. In contrast, the two accuracy, thetwo sensitivity, and two specificity, which were not statistically significant, P>0.05. Therewas no mean in local strain ratio method and with the5points method in diagnosis of breast benign and malignant tumors4.False negative and false positive: in elasticity imaging of local strain ratio methodfor the determination of malignant from benign breast lesions occur when8false negativecases,accounting for11.3%, false positive cases, accounting for9.4%;5points method tojudge the malignant from benign breast lesions appear when the false positive of9falsenegative, accounted for12.7%, false positive cases5,15.7%.Conclusion1.Elastography imaging of local strain rate ratio method and5point method for thediagnosis of benign and malignant breast lesions have a certain degree of accuracy,sensitivity and specificity. They are both effective auxiliary method in diagnosde breastbenign and malignant tumors.2.There were no significant difference with strain rate ratio method and5point methodin judging benign and malignant breast tumors in terms of accuracy, sensitivity and specificity.3.Two kinds of methods have some false positive, false negative, application ofultrasonic elasticity imaging process must be comprehensive cancer by two-dimensionaland color Doppler information.