The Research Of The Diagnostic Value Of ARFI Combined With The Three-dimensional Ultrasound In BI-RADS Category 4 Breast Lesions

Object By analyzing the ultrasonographic characteristics of the breast tumors two-dimensional ultrasound,ARFI and three-dimensional ultrasound,this paper was to explore the diagnostic value of ARFI combined with the three-dimensional ultrasound in BI-RADS category 4 Breast Lesions,with the pathologic results as the gold standard,and to improve the diagnosis coincidence rate of ultrasound to Breast Lesions.Material and Methods77 cases of BI-RADS category 4 Breast Lesions was selected by the two-dimensional ultrasonic scan,and all the cases had been examind by ARFI and three-dimensional ultrasound and accepted surgical treatment in Shenzhen Peoples Hospital.With the pathologic results as the gold standard,used IBM SPSS22 statistical softwave to draw ROC curve by SWE in order to obstain the best diagnostic threshold.With the standard that SWE higher than the best diagnostic threshold or the present of convergence sign in the coronal plane of three-dimensional ultrasound in the same tumor,analyzed the diagnostic sensitivity,specificy and accuracy of ARFI combined with the three-dimensional ultrasound for BI-RADS category 4 breast lesionsResults77 cases of BI-RADS category 4 Breast Lesions,of which 46 were maglinant and 31 were benign.The results of ARFI showed that the SWE of the maglinant lesions was2.4-9.0m/s(mean 5.80±1.78m/s),and the benign 1.6-6.4m/s(mean 2.56±1.12m/s).By the two sanmple t test,there was statistical significance in the two groups of mean differences(t=4.649,P=0.000),Which indicated that the SWE of the breast cancer was obviously higher than the benign Lesions.With the pathologic results as the gold standard,used the SWE of Breast Lesions to draw ROC curve,the area under the curve was 0.910,the diagnostic valve was high.The best diagnostic threshold of ARFI diagnosis of benign and malignant was 4.85m/s.With a standard of the SWE higher than the best diagnostic thresholdthe,the diagnostic sensitivity,specificy and accuracy for which breast Lesions were benign or malignant was 71.7%,90.3%,79.2%respectively.the diagnostic sensitivity,specificy and accuracy for which breast Lesions were benign or malignant of the convergence sign in the coronal plane of three-dimensional ultrasound were 69.7% 、 90.3% 、 77.9% respectively.With the standard that SWE higher than the best diagnostic threshold or the present of convergence sign in the coronal plane of three-dimensional ultrasound in the same tumor,the diagnostic sensitivity,specificy and accuracy for which breast Lesions were benign or malignant were 89.1%、87.1%、88.3% respectively.Comparing the diagnostic valve of ARFI and three-dimensional ultrasound for BI-RADS category 4 Breast Lesions,there was no statistical significance for the two diagnostic methord(P=0.648).Comparing the diagnostic valve of ARFI and ARFI combined with three-dimensional ultrasound for BI-RADS category 4 Breast Lesions,there was statistical significance for the two diagnostic methord(P=0.004).Comparing the diagnostic valve of three-dimensional ultrasound and ARFI combined whih three-dimensional ultrasound for BI-RADS category 4Breast Lesions,there was statistical significance for the two diagnostic methord(P=0.002),Which indicated that the diagnosis coincidence rate of ARFI combined whih three-dimensional ultrasound to breast Lesions was obviously higher than using ARFI and three-dimensional ultrasound respectively.The diagnostic sensitivity,specificy and accuracy of BI-RADS system for breast cancer was 78.1%,80.0%,79.2% respectively.After correction of ARFI combined whih three-dimensional ultrasound,the diagnostic sensitivity,specificy and accuracy of BI-RADS system for breast cancer was 89.1%,83.9%,87.0% respectively.Comparing the diagnostic valve of BI-RADS system and corrected system for Breast cancer,there was statistical significance for the two diagnostic methord(P=0.018),Which indicated that the diagnosis coincidence rate of the corrected system to breast cancer was obviously higher than BI-RADS system.Conclusions1.The diagnosis coincidence rate of ARFI,three-dimensional ultrasound and ARFI combined whih three-dimensional ultrasound to BI-RADS category 4 breast lesions was 79.2%,77.9%,88.3% respectively.2.Comparing the diagnostic valve of ARFI and three-dimensional ultrasound for BI-RADS category 4 breast besions,there was no statistical significance for the two diagnostic methord(P=0.648).3.The diagnosis coincidence rate of ARFI combined whih three-dimensional ultrasound to BI-RADS category 4 breast lesions was obviously higher than using ARFI and three-dimensional ultrasound respectively(p=0.002).4.The diagnosis coincidence rate of the corrected system to breast cancer was obviously higher than BI-RADS system(p=0.018).