The Value Of Ultrasonic Elastography In The Diagnosis And Prognosis Of Breast Lesions

[Objective] to investigate the value of Ultrasonic Elastography(UE) in the differential diagnosis of malignant and benign breast lesions,and preliminarily explore the correlation of the UE scores and the ratios of traced areas in UE versus two-dimensional ultrasound(2D-US) with axillary lymph node metastasis and the expression of Ki-67 in breast cancer.[Methods]105 patients with 130 breast lesions were examined with conventional ultrasound and UE, the lesions were evaluated by elastic scores,which were classified into five grades,and the traced areas of the lesions were measured respectively on UE and 2D-US, the ratios of traced areas were automatically calculated by system software.All patients were confirmed pathologically and the expressions of Ki-67were detected by immunohistochemistry technique in patients with breast cancer.[Results](1) 45 patients with 70 lesions were in the benign group and 60 patients with 60 lesions were in the malignant group.(2) the sensibility,specificity,accuracy of conventional ultrasound for differentiation were 91.67%,88.57% and 90.00%, respectively.(3) the sensibility,specificity,accuracy of the method of UE scores for differentiation were 88.33%,74.29% and 80.77%,respectively. (4) the sensibility,specificity,accuracy of the method of the ratios of traced areas for differentiation were 73.33%,82.86% and 78.46%, respectively. (5) those of the method of combination of UE and conventional ultrasound were 98.33%,95.71% and 96.92%, respectively.The accuracy of the method of combination of UE and conventional ultrasound for differentiation was statistically significant higher than those of conventional ultrasound,UE scores and the method of the ratios of traced areas(P<0.05). (6)There was no correlation between the elastic scores with axillary lymph node metastasis or Ki-67 expression in breast cancer(P>0.05).(7) There was no correlation between the ratios of traced areas in UE versus 2D-US and axillary lymph node metastasis of breast cancer(P>0.05),but positively correlated with Ki-67expression(r=0.368, p=0.004).[Conclusions] (1) The accuracy of the method of UE scores or the ratios of traced areas in UE versus 2D-US by singlely using in the differential diagnosis of malignant and benign breast lesions is lower than conventional ultrasound, The accuracy of combined diagnosis improves remarkably.(2) There was no correlation between the elastic scores with axillary lymph node metastasis or Ki-67 expression in breast cancer, the result represents:the elastic score is not the indicator of prognosis judgement of breast cancer.(3) There was no correlation between the ratios of traced areas in UE versus 2D-US and axillary lymph node metastasis of breast cancer,but positively correlated with Ki-67 expression,the result represents:the ratios of traced areas can not prognosticate axillary lymph node metastasis but helpul for knowing the proliferation of breast cancer cells and evaluating the prognosis.