Study On The Relevant Parameters Of Real-time Ultrasonic Elastography In Identifying Nature Of Breast Lumps

Objective: To investigate the value of real-time elastography relevant parameters for identifying the nature of breast lumps.Method: 86 patients with 105 breast lumps were examined by gray-scale ultrasound and UE(Ultrasonic Elastography) imaging independently.The gray-scale sonographic features, UE grade,the rate of elastic strain ratio,area ratio and the shortest vertical distance from the lumps to body surface should be observed and recorded. Following-up the pathologic results as gold standards for the diagnosis to make a retrospective analysis of the image characteristics and compare the value of these parameters. The lumps should be grouped by their pathological diagnosis. The diagnostic prediction of elastic strain ratio and area ratio can be get to draw ROC curves, which in turn can reflect the clinical value and locate the optimal oprating point.Result:(1) 42 malignant lesions and 44 benign lesions were diagnosed correctly by gray-scale ultrasound among the 105 breast lumps. The sensitivity, specificity and accuracy were 82.35%(42/51)、81.48%(44/54)、81.90%(86/105). 41 malignant lesions and 46 benign lesions were diagnosed correctly by UE grades. The sensitivity, specificity and accuracy were 85.42%(41/48)、80.70%(46/57)、82.86%(87/105)。Combined application of those methods make diagnosis of 49 malignant lesions and 48 benign lesions, which sensitivity, specificity and accuracy were 90.74%(49/54)、94.12%(48/51)、92.38%(97/105).(2)Make the lumps into groups by their pathological diagnosis. The diagnostic prediction of the SR rate(elastic strain ratio)can be get todraw ROC curve.The Az(Area Under Curve) was 0.821 and 1.18 was located as the optimal oprating point.The sensitivity, specificity and accuracy were 79.63%(43/54)、82.35%(42/51)、80.95%(85/105). The Az(Area Under Curve) was 0.852 and 1.58 was located as the best cut-off point of AR by the same method. Its sensitivity, specificity and accuracy were 84.00%(42/50)、81.82%(45/55)、82.86%(87/105). Conclusions:1.UE grades,SR rate and AR were all proved to be valuable in identifying benign and malignant of breast lumps. There weren’t statistical difference among those three parameters or between these parameters and gray-scale ultrasound in their sensitivity, specificity and accuracy.2.The judgment accuracy of combined application of high-frequency ultrasound and UE scoring is higher than the single use each related parameters of UE imaging. The differences were statistically significant.3.1.58 and 1.18 were got as the the optimal oprating points of SR rate and AR separately by ROC curves.