The Study Of The Parameters Of Sonoelastography In The Diagnosis Of Breast Lesions

Objective:To evaluate the value of elasticity parameters on sonoelastography in the differential diagnosis of breast lesions, and establish the benign and malignant diagnosis standard of each parameter; on these foundations, we explore the diagnosis value of strain ratio (SR) when the patients were divided into two groups with the condition of menopause.Material and Methods:286patients with300breast lesions were examined during April2011to July2011in Huashan hospital. All the lesions were confirmed by pathology(180benign and120malignant). The pathologic diagnosis was as gold standard. All patients were female and average age is46±14. The instrument was Hitachi EUB-7500and the probe frequency was from7.5MHz to13MHz Ultrasonography and ultrasonic elastography were used to examined300breast lesions, classify these lesions on sonoelastography with BI-RADS, and measure the parameters of each lesions which were5-scoring system, area ratio and strain ratio (SR1was calculated using a same-level and normal-appearing breast region as a reference; SR2was calculated using subcutaneous fat as a reference) on ultrasonic elastography. The SPSS17.0software were used to analyze the data.Results:1. The mean elastic scores±SD on sonoelastography were4.17±0.88for benign lesions and2.22±0.76for malignant lesions, p<0.01; when the elasticity mark≥3was defined malignancy, the sensitivity, specificity and accurate rate were94.2%、81.1%、86.3%;when the elasticity mark≥4was defined malignancy, the sensitivity, specificity and accurate rate were80%、91.1%、86.7%.2. Analyse the receiver operating characteristic curve(ROC) of area ratio, the cutoff point is1.2, the area under the curve is0.896, the sensitivity, specificity and accurate rate were92.5%、80.6%、83%; the mean value of area ratio was1.12 ±0.3for benign lesions, and the mean value of area ratio was1.62±0.42for malignant lesions,p<0.01.3. Analyse the receiver operating characteristic curve(ROC) of SRI and SR2, the cutoff point of SRI is2.44, its area under the curve is0.803, its sensitivity, specificity and accurate rate were64.2%,84.4%,76.3%, the cutoff point of SR2is2.7, its area under the curve is0.782, its sensitivity, specificity and accurate rate were70%、73.9%、72.7%; the data were analyzed by t test, and we got the mean value of SRI were1.65±0.87for benign lesions and3.36±2.21for malignant lesions, p<0.01; and the mean value of SRI were2.23±1.11for benign lesions and4.31±2.6for malignant lesions,p<0.01.4. the receiver operating characteristic curve (ROC) of premenopausal and postmenopausal SRI, the cutoff point of premenopausal SRI is2.35, and the cutoff point of postmenopausal SRI is2.52. We choose different standard of SRI by the condition of menopause, the sensitivity、specificity and accurate rate was79.2%、90%、85.7%respectively.5. Analyse the receiver operating characteristic curve(ROC) of premenopausal and postmenopausal SR2, the cutoff point of premenopausal SR2is2.6, and the cutoff point of postmenopausal SR2was2.67. We choose different standard of SR2by the condition of menopause, the sensitivity、specificity and accurate rate was59.2%、77.8%、70.3%respectively.Conclusions:1. The parameters of sonoelastography have high diagnosis value for differentiating between benign and malignant breast masses, especially the5-point scoring with sonoelastography and area ratio have higher accurate rate.2. The diagnosis value of strain ratio was improved after the patients were divided into two groups by the condition of menopause.