Diagnostic Value Of Shear Wave(SWE) And Acoustic Pulse Radiation Force Elastography(ARFI) In Solid Breast Lesions

Objective:To investigate and compare the diagnostic value of shear wave elastography(SWE)and acoustic pulse radiation force elastography(ARFI)in differentiating benign and malignant breast lesions.Methods:98 patients(108 lesions)with breast lesions from February to July2018 were prospectively collected.All lesions were examined by acoustic pulse radioelastography and shear wave elastography.The VTQ value of lesions in acoustic pulse radioelastography,Emax,Emean and Emin of lesions in shear wave elastography were observed and recorded.The data were analyzed by SPSS22.0 software.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the two elastography techniques and their combination in the diagnosis of benign and malignant breast lesions were calculated with pathological results as the gold standard.The diagnostic effect of each index on benign and malignant tumors was analyzed by ROC curve.The differential diagnostic value of SWE,ARFI and SWE combined with ARFI in breast lesions was compared and analyzed.Results:The results of ARFI analysis showed that the AUC was 0.765,P<0.001,indicating that ARFI could be used for the diagnosis of breast lesions.When VTQ was more than 3.50m/s,the sensitivity,specificity,positive predictive value,negative predictive value and Yoden index were 65.00%,85.42%,84.78%,66.13%and 0.504respectively.The results showed that Emax(Z=6.782,P<0.001)and Emean(Z=4.186,P<0.001)of malignant patients were higher than those of benign patients,and the differences were statistically significant.There was no significant difference in Emin between benign and malignant patients(Z=1.555,P=0.120).SWE indicators for the diagnosis of breast cancer benign and malignant showed that Emax had the best diagnostic effect,and then compared Emax with VTQ.The area under the curve showed that Emax had better diagnostic effect than VTQ.The difference was statistically significant(Z=2.049,P=0.040).The comparison results showed that the diagnostic accuracy of Emax was higher than VTQ in malignant patients,and the difference was statistically significant(x~2=6.400,P=0.011).In benign patients,Emax had better diagnostic effect than VTQ.The diagnostic accuracy of VTQ in sex patients was higher than that of Emax,but there was no significant difference(x~2=0.300,P=0.584).When ARFI and SWE were combined,the sensitivity,specificity,positive predictive value,negative predictive value and Yoden index were 96.67%,79.17%,85.29%,95.00%and 0.758 respectively.The combination of ARFI and SWE can improve the detection rate and accuracy of breast malignant lesions.Conclusion:1.ARFI and SWE have good clinical value in differential diagnosis of breast lesions.2.The parameters of SWE in the diagnosis of benign and malignant breast lesions showed that Emax was better than Emean in the diagnosis of breast lesions,and Emax was the best in the diagnosis of breast lesions.3.SWE is slightly better than ARFI in differential diagnosis of benign and malignant breast lesions,and SWE is better than ARFI in diagnosis of malignant breast lesions,and the diagnostic accuracy of benign breast lesions is similar.4.The combination of ARFI and SWE can improve the sensitivity and accuracy of breast lesion diagnosis.