The New Algorithm Of Shear Wave Elastography In The Application Of Breast Nodules

Background and PropuseShear wave elastography（SWE）is a new tissue strain imaging technology,as anintuitive,quantitative ultrasound technology,SWE has been widely used in thedifferential diagnosis of breast nodules.Previously reports had the point that the areaof nodules are different in two-dimensional ultrasound and in elastography,in theelastography malignant nodules are larger than two-dimensional ultrasound，while thebenign ones are close.Therefore，the different nature of the images obtained in theelastography and two-dimensional ultrasound can discriminate the benign andmalignant breast nodules.This study will measure the Young，s modulus of internaland surrounding areas of nodules through SWE quantitative techniques，evaluate thefunction of SWE in the differential diagnosis of benign and malignant breast nodules.Materials and Methodsusing SuperSonic Imagine SWE AixPlorer type ultrasonic diagnosis instrument,application of shear wave elastography technology, measuring56patients with89breast nodules the average Young’s modulus (Emean), the maximum value (Emax), standard deviation (SD) within nodules and Emean around nodules(nodule0.37timesthe diameter of the two-dimensional glands as nodules surrounding parts). Withpathological findings as a "gold standard", draw the ROC curve, determine itsdiagnostic value.Results①the benign group: Emean, Emax and SD within nodules were (37.65±7.99)kPa,(81.82±12.78) kPa,(19.69±6.16) kPa,respectively, Emean around nodules was(33.29±10.19) kPa; malignant group: Emean, Emax and SD within nodules were(50.87±17.19) kPa,(114.26±30.02) kPa,(27.92±13.55) kPa,respectively, Emeanaround nodules was (73.26±22.49) kPa. The differences of Emean, Emax and SDwithin benign and malignant nodules were statistically significant (P <0.05). Thedifference of Emean around benign and malignant nodules was statisticallysignificant.②Through the ROC curve drawing,the area under curve(AUC) of Emean,Emax and SD within nodules were0.736,0.855,0.734, respectively, the critical pointwere40.15kPa,90.5kPa,22.95kPa,respectively. The area under the curve (AUC) ofEmean around nodules was0.940, the critical point is44.55kPa.ConclusionEmean, Emax and SD within nodules provide the basis for the differentialdiagnosis of benign and malignant breast nodules, Emean around nodules provides anew approach, superior to Emean, Emax and SD within nodules.