The Diagnostic Value Of Quantitive Ultrasound Elastography And Real-time Shear-wave Elasticity Imaging To Breast Solid Lesions

Part Ⅰ The Diagnostic Value of Quantitive Ultrasound Elastography to Different Diameter Breast Solid LesionsObjectiveTo explore the clinical value of entire strain ratio(ESR)and localized strain ratio(LSR) of real-time elasticity imaging to different diameter benign and malignant breast solid lesions.MethodsEighty-three small breast lesions (diameter≤10mm, group Ⅰ) and110large breast lesions (diameter>10mm, group Ⅱ) were preoperation examined with entire strain ratio(ESR)and localized strain ratio(LSR) methods respectively. According to results of UE, pathology was as golden standard for diagnosis, receiver operating characteristic (ROC) curves were used to explore the optimized cut-off points of them respectively. According to optimized cut-off points, and the sensitivity、specificity、 accuracy and failure rate of ESR and LSR for diagnosing breast solid lesions (group Ⅰ、Ⅱ) was calculated and compare their diagnostic values respectively. Results1. For ESR study, ROC curves revealed an area under the curve of0.904±0.024, the optimized cut-off point was3.06, and the sensitivity、specificity、accuracy、failure rate for diagnosing breast lesions was90.5%(19/21)、96.8%(60/62)、95.2%(79/83)、9.5%(2/21) in group I and78.4%(29/37)、84.9%(62/73)、82.7%(91/110)、21.6%(8/37) in group II, respectively.2. For LSR study, ROC curves revealed an area under the curve of0.944±0.013, the optimized cut-off point was31.26, and the sensitivity、specificity、accuracy、 failure rate for diagnosing breast lesions was95.2%(20/21)、98.4%(61/62)、97.6%(83)、4.8(1/21)%in group I and83.8%(31/37)、91.8%(67/73)、89.1%(98/110)、16.2%(6/37) in group Ⅱ, respectively.3. Group Ⅰ is superior to Group II in the diagnosis accuracy both ESR and LSR (P<0.05)。4. The diagnosis difference was not statistically significant both ESR and LSR in group Ⅰ (P>0.05)。5. LSR is superior to ESR in the diagnosis accuracy for breast lesions in group Ⅱ (P<0.05).Conclusion1. Quantitive ultrasound elastography (Both ESR and LSR) are helpful in differentiating breast small lesions.2. LSR is superior to ESR in differentiating breast large lesions. Part Ⅱ The Tissue Characterization of Real-time Shear-wave Quantitive Elasticity Imaging to Breast Solid LesionsObjectiveTo evalue the mean elasticity value of bengin and malignant breast solid lesions with supersonic shear wave Elastography (SWE).Then to observe the value of the tissue characterization with SWE.MethodsReal-time Shear-wave Quantitive Elasticity Imaging were preoperation performed with106breast solid lesions.According to results of SWE, pathology was as golden standard for diagnosis, The mean elasticity value of bengin and malignant breast solid lesions was calculated and compare their diagnostic values respectively.Results1. Pathology was as golden standard for diagnosis, eighty-two breast solid lesions were bengin and24breast solid lesions were. The mean elasticity value of bengin breast solid lesions was (26.32±13.95) Kpa, The mean elasticity value of malignant breast solid lesions was (49.85±28.37) Kpa, The mean elasticity value of malignant breast solid lesions were higher than this of bengin breast solid lesions (P<0.05)2. According to the order from low to high, The mean elasticity value of Infiltrating ductal carcinoma was higher than this of mastopathy. The mean elasticity value of mastopathy was higher than this of fiberadenoma. The mean elasticity value of fiberadenoma was higher than this of mammary gland and fatty tissue (P<0.05)Conclusion1. SWE can provide real-time quantitative mean elasticity value of different breast solid lesions, and has a good repeatability.2. The mean elasticity value with SWE can differentiate the bengin and malignant breast solid lesions. 3. SWE can realize the tissue characterization of breast solid lesions.