Study On The Parameters Of Ultrasonic Elastography In Diagnosisof Breast Masses

Objective: To investigate the diagnostic value of ultrasonic elastography(UE) for breastlessions in order to make clinical effective treatment.Method:70patients with80lessions were examind by gray-scale sonogaphy andultrasonic elastography before surgery. These gray-scale pictures、 ultrasonicelastography imaging、area ratio imaging and strain ratio imaging were saved into thecomputer. Analyzed and compared with the sensitivity, specificity, accuracy ofgray-scale sonogaphy and UE and the two combined with pasologic diagnosis as a goldstandard. Last receiver operating characteristic curve was plotted analyzing thediagnostic value of area ratio and strain ratio. P<0.05is looked on as the significantdifference.Result:(1) The sensitivity, specificity and accuracy of gray-scale sonogaphy,elasticity stiffness score and the two combined in diagnosing benign and malignantbreast lessions were72.41%、82.35%、81.25%；72.41%、96.08%、87.50%；82.76%、98.04%、92.5%, respectively. The accuracy of the two combined was higher than thoseof gray-scale sonogaphy and UE scoring method compared by the McNemar χ2test(P<0.05).(2) With pasologic diagnosis as a gold standard, ROC curves were obtainedto assess the performance of the area ratio. The Az were0.895.1.17was the best cutoffpoint of the area ratio for differentiating benign from malignant breast lessions. Thesensitivity, specificity and accuracy were89.70％,84.30％,86.25％. The accuracy ofarea ratio was not significantly different with those of UE scoring method fordifferenttianting benign and malignant breast lessions.(P>0.05).(3) With pasologic diagnosis as a gold standard, ROC curves were obtained to assess the performance ofthe strain ratio. The Az were0.906.1.61was the best cutoff point of the strain ratio fordifferentiating benign from malignant breast lessions. The sensitivity, specificity andaccuracy were86.20％,74.50％,78.25％. The accuracy of strain ratio was notsignificantly different with those of UE scoring method and area ratio fordifferenttianting benign and malignant breast lessions (P>0.05).(4) The accuracy ofdifferent depth for UE scoring was not significantly different for differenttiantingbenign and malignant breast lessions (P>0.05).Conclusions: UE is very useful in differentiating benign and malignant breastlessions. Its accuracy was higher than those of CDFI and SD, which help them fordifferentiating benign and malignant breast masses. The combination of CDFI, SD andUE could improve diagnostic accuracy and imply less misdiagnosis in clinical practice.The accuracy of the two combined was higher than those of gray-scale sonogaphy andsingle UE parameter. But there have some overlap in diagnosing whether the breastlession is benign or not. To combine the parameter at the right moment is helpful toimprove the diagnose rate of special breast lessions.