Study On The Clinical Application Of Shear Wave Elastography In Differential Diagnosis Of Benign And Malignant Breast Lesions

Objective To explore the value of the 2013 version of the Ultrasound Breast Imaging Reporting and Data System(BI-RADS)classification diagnostic criteria,ultrasound shear wave elastography(SWE)and their combination identify benign and malignant breast lesions by comparing the diagnosis efficiency of the three methods and analyzing the SWE characteristic of breast lesions.Methods According to the inclusion and exclusion of the study,155 solid breast masses in 175 women from September 2017 to May 2015,all the lesions had surgical excision or tissue biopsy.Next,all the masses were examined with ultrasound and judged to be benign or malignant by BI-RADS classification criteria.Then all the masses were examined with shear wave elastography(SWE),to obtain shear wave quantitative parameters of benign and malignant breast lesions.The pathological results were used as the gold standard to construct the receiver operating characteristic curve of shear wave quantitative parameters,which were used to compare the diagnostic value of these quantitative parameters.Then construct the receiver operating characteristic curve of the subjects,which were used to compare the diagnostic value of the two methods alone and in combination.Results 1.The area under curve of the Emax value,the Emean value and the Emin value to differential diagnosis of benign and malignant breast nodules were 0884、0.297 and 0.685,respectively.Comparison of the AUC between the Emax value and Emean value has a significant difference(Z=4.266,P=0.000).When the cut-off value equaled 54.75 k Pa,the sensitivity was 84.62%,specificity was 81.44%,accuracy was 82.86%,PPV was 78.57% and NPV was 86.81%..2.The area under curve of the BI-RADS classification diagnostic criteria,the Emax value,and the combined of the two methods to differential diagnosis of benign and malignant breast nodules were 0913、0.884 and 0.957,respectively.Comparison of the three,combination has a significant difference between BI-RADS classification and SWE.(BI-RADS classification vs SWE: Z=1.407,P=0.081;BI-RADS classification vs.combination: Z=2.883,P=0.002;SWE vs.combination: Z=4.081,P=0.000).3.BI-RADS classification has the best sensitivity and the combination has the best specificity(P=0.000).The combination of BI RADS classification and SWE technology can reduce over-diagnosis of benign lesions(P=0.000).Conclusion: 1.SWE technology can differential diagnosis of benign and malignant breast lesions,and it has good repeatability.2.The Emax value has the best diagnosis efficiency among the three quantitative parameters.The Emin value doesn’t make sense in diagnosis.3.The combination of BI-RADS classification and SWE technology can improve the diagnostic accuracy of breast lesions.4.SWE technology could be one of the available way to differential diagnosis breast lesions,but gray-scale ultrasonography is the foundation of diagnosis.