The Application Of Elastography In Diagnosis Of Breast Solid Lesions

PART I THE CLINICAL APPLICATION OF ACOUSTICRADIATION FORCE IMPULSE TECHNOLOGY（ARFI） INQUANTITATIVE DIFFERENTIAL DIAGNOSIS OF BREASTLESIONSObjective To explore the clinical application of ARFI technology inquantitative differential diagnosis of breast lesions.Methods During May2011to March2012,175patients who came toour hospital for routine examination and finally got pathological results wereincluded.There were227solid breast lesions,with113lesions on the leftside and the other112on the right side.The pathological results were that179lesions were benign and58ones were malignant. First，getting thetraditional ultrasound message of the lesions. Then，using ARFI technologyto measure the shear wave velocity (SWV)，the region of interest (ROI) wasrespectively placed in the internal of the lesion、marginal between the lesion and the parenchyma and the parenchyma.Every location was measuredten times and got the average value as final result for statistical analysis.Usingpathological results as gold standard.Results The internal and marginal SWV of the benign lesions were2.38±0.52m/s、2.14±0.61m/s and that of malignant lesions were7.62±2.51m/s、5.32±2.63m/s.The SWV of the parenchyma was1.46±0.44m/s.The internal and marginal SWV of malignant lesions were both higherthan benign ones(P<0.05);The internal and marginal SWV of benign lesionswere both higher than the parenchyma(P<0.05). With the cutoff value of3.29m/s,the sensitivity、specificity、accuracy of ARFI technology to predictmalignancy was78.9%、98.3%、77.5%and the area under the curve was0.914.Conclusion ARFI technology is a quantitative elasticity measurement,it has very high clinic value in the diagnosis and differential diagnosis ofbreast lesions. PART II THE CLINICAL RESEARCH OF ELASTOGRAPHYIN DIAGNOSING BI-RADS IV BREAST LESIONSObjective To explore the diagnosis values of EI and ARFI technologyin BI-RADS IV breast lesions.Methods During May2011to March2012,52BI-RADS IV lesionswith pathological results were included.28lesions were benign and24oneswere malignant.First, using EI technology and Itoh’s5scores. The diagnosisstandard was that lesions with1、2、3score were benign and lesions with4、5score were malignant. Second,using ARFI technology to measure theshear wave velocity (SWV)，the region of interest (ROI) was respectivelyplaced in the internal of the lesion、marginal between the lesion and theparenchyma and the parenchyma. All locations were measured ten times andgot the average value as result for statistical analysis.Using pathologicalresults as gold standard.Results The sensitivity,specificity, accuracy of EI to predictmalignancy was78.6%,100%,88.5%while that of ARFI was75%,99.3%,67.9%respectively. There was no significant difference between them indifferential diagnosis of BI-RADS IV breast lesions (P>0.05).Conclusion ARFI and EI technology has high specificity in differentialdiagnosis of BI-RADS IV breast lesions,so it provides a new method for diagnosis and differential diagnosis of breast lesions.