The Study Of Shear Wave Elastography Combined With Superb Microvascular Imaging In The Evaluation Of Neoadjuvant Chemotherapy For Breast Cancer

Objective:To investigate the application value of the therapeutic effect of neoadjuvant chemotherapy in patient with breast cancer by superb microvascular imaging and shear wave elastography.Methods:Sixty-three breast cancer patients undergoing NAC,with preoperative crude needle puncture pathology and postoperative surgical pathology as the gold standard,underwent S.2 D ultrasound,SWE and SMI both before and after NAC.The length,width,thickness and volume of cancer lesions before and after NAC under two-dimensional ultrasound were observed respectively;In SMI mode,blood flow within and around NAC cancer classification,resistance index(resistance index,RI)and the peak blood flow velocity(peak systolic velocity,Changes in PSV);Maximum Young’s modulus value after NAC in SWE mode(maximum Young’s modulus value,Emax),mean Young’s modulus value(mean Young’s modulus value,Emean)and changes in the ratio(Ratio)to the surrounding normal tissue at the same depth;And the changes of the above parameters when combining the SMI and SEW.The analysis was also compared with the pathological conditions.Results:A total of 63 primary cancer foci occurred in 63 breast cancer patients,2 D ultrasound:NAC(3.22±0.89)cm,cm(2.39±0.56)cm,(1.70±0.42)cm,mean volume(17.68±2.61)cm3,(1.54±0.58)cm,(1.32±0.46)cm,(0.99±0.42)cm,mean volume(7.68±2.61)cm3.The length,width,thickness and volume of NAC were reduced,and they were significant by paired t-test(P<0.001).SMI suggested that cancers before NAC had grade Ⅱ and Ⅲ flow,with 0,Ⅰ,Ⅱ and Ⅲ at 0%,12.7%,55.6%,31.7%,0,Ⅰ,Ⅱ,0,Ⅰ,Ⅱ and Ⅲ at 15.9%,63.5%,17.5%,3.1%,respectively,as before NAC(P<0.001).SWE:Emax 48～295 kPa,average(182±53)kPa;Emean 40～280 kPa,average(152±40)kPa;Ratio 9.2～30.3,average(18.6±11.3).After NAC treatment,Emax was 25～164kPa,average(72±33.8)kPa;Emean 5～153kPa,average(58±37)kPa,Ratio 2.8～25.6 and average(5.6±4.5).Emax,Emean and Ratio values decreased in NAC and were statistically significant(P<0.001).The efficacy of SMI,SWE and SMI with SWE suggested that the changes of SMI parameters indicated 42 effective(CR+PR)and 21 invalid(SD+PD).Changes in SWE parameters indicated 45 valid(CR+PR)and 18 invalid(SD+PD).SMI and SWE suggested 48 valid(CR+PR)and 15 invalid(SD+PD).After NAC,50 cases(G3+G4+G5)and 13 cases(G1+G2)were not effective.NAC efficacy and pathological response consistency:2 D volume changes are moderate consistency((Kappa=0.58);SMI changes are high consistency(Kappa=0.70);SWE changes are high consistency(Kappa=0.68);SMI and SWE changes are high consistency(Kappa=0.76).Conclusion:Two-dimensional ultrasound,SWE and SMI can be used to evaluate the efficacy after NAC in breast cancer patients,but the combination of SWE and SMI has a high consistency between NAC efficacy and pathological biopsy,with higher clinical diagnostic value.