Comparative Analysis Of Ultrasonographic Characteristics And Diagnostic Value Of Ultrasonography And Mammography In Complex Cystic Breast Lesions

Objective:In this study,the ultrasonic characteristics of complex cystic breast lesions were discussed,compares and analyzes the diagnostic efficiency of ultrasound and molybdenum target X-ray examination,so as to improve the understanding of ultrasound and radiologists on complex cystic breast lesions,so as to improve the diagnostic level of complex cystic breast lesions.Methods:A total of 162 cases of complex cystic breast lesions were retrospectively analyzed in 151 patients who underwent breast ultrasound examination and were confirmed by pathology in our hospital from January 2019 to June 2020.All lesions were classified according to ultrasonographic characteristics(type I:cystic masses with thick wall or thick space;type Ⅱ: cysts have one or more papillary solid nodules;type Ⅲ: mixed cystic solid lesions with cystic composition>50%;Type Ⅳ: cystic solid mixed lesions with a solid component>50%);Take pathological results as the "gold standard",the malignant rate of various types of lesions was calculated,and the relationship between benign and malignant lesions was evaluated.Among them,132 patients(141 lesions)underwent mammography at the same time to compare the diagnostic efficacy of ultrasound and mammography.Results:1.151 patients were included in this study,with a total of 162 complex cystic breast lesions,including 118 benign and 44 malignant lesions,with a malignant rate of27.2%(44/162).2.The malignant rates of type Ⅰ,Ⅱ,Ⅲ and Ⅳ lesions in 162 complex cystic breast lesions were 12.5%(4/32),16.6%(3/18),21.2%(7/33)and 37.9%(30/79),respectively,and there was statistical significance(P=0.021).3.In univariate analysis of ultrasonographic features,posterior echo of lesions was not associated with malignant tumor(P=0.393).In multivariate Logistic regression analysis,irregular shape,unclear boundary,calcification and abnormal axillary lymph nodes were associated with malignant lesions(P<0.05).The order of malignant risk was calcification(OR=7.097)>irregular shape(OR=3.707)>unclear boundary(OR=3.361)>abnormal axillary lymph nodes(OR=3.324).4.132 patients(141 lesions)underwent mammography at the same time,118 lesions(80 benign and 38 malignant)were detected by mammography,the detection rate was83.7%(118/141),and the maximum diameter of lesions was(2.5±1.8)cm.There were 23 missed lesions(20 benign and 3 malignant),and the maximum diameter of missed lesions was(1.3±0.8)cm.The difference between the maximum diameter of detected and missed lesions was statistically significant(P<0.05).5.The sensitivity,specificity,accuracy and AUC of ultrasonography in diagnosing malignant lesions were higher than those of mammography,and the difference in specificity between them was statistically significant(P < 0.05).Conclusion:1.Ultrasonography is helpful to improve the detection rate of breast complex cystic lesions.2.Ultrasonography of complex cystic lesions of breast is complex and diverse,and ultrasound can accurately identify the cystic solid lesions,which can be classified as BI-RADS 4B according to the malignant rate.3.Ultrasonography is more effective than mammography in diagnosing complex cystic lesions.