The Contrastive Study Of Conventional Ultrasound Compression Elastography(CE) And Acoustic Radiation Force Impulse Imaging(ARFI) In The Differential Diagnosis Of Benign And Malignant Breast Tumors

Background Tumor of breast is one of the most common tumor in women in our country,breast cancer is increasingly becoming the top killer of women’s health.Early detection and diagnosis of breast cancer are particularly important for the treatment and prognosis of patients and the quality improvement in life. Conventional ultrasound (CUS) is the most popular means of checking in breast examination and cancer screening, but there are some limitations for the qualitative diagnosis of breast tumors. Compression elastography (CE) and the acoustic pulse radiation force imaging (ARFI) are new developments of ultrasonic examination means, and it is reported that both of these two kinds of new technologies have a higher value for benign and malignant breast tumors, but there is a lack of value comparative study on conventional ultrasound(CUS), CE and ARFI in differential diagnosis of benign and malignant breast tumors.Objective Research in ultrasonographic features of benign and malignant breast tumors with conventional ultrasound, CE and ARFI respectively, then the potential clinical application value of these three kinds of ultrasonic inspection technology and its the diagnostic index for the differential diagnosis of benign and malignant breast tumor is discussed and compared.Materials and Methods76patients, who were treated and confirmed by operation or biopsy pathology during the period from2012April to2012December in our hospital, have a total of95breast lumps.Use Siemens ACOUSON S2000ultrasound diagnostic apparatus, equipped with ARFI software,9L4high frequency probe and frequency of4MHz-9MHz, as well as Hitachi ALOKA Prosound F75ultrasonic diagnostic apparatus, equipped with CE software, high-frequency probe,frequency of6.4MHz. All lumps are respectively examined by conventional ultrasound, CE and ARFI to get Two-dimensional gray scale and color Doppler sonography, CE elastic score and strain ratio(strain ratio-SR) and virtual touch tissue quantitative (VTQ) value of breast lumps, we then use three kinds of ultrasonic inspection methods CUS, CE and ARFI for the benign and malignant breast masses in differential diagnosis, and the results are analyzed by double blind method. First, calculating the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of malignant breast tumor which are diagnosed by various methods and indexes; second, obtaining area under the curve (AUC) and its optimal truncation point by drawing ROC curve of VTQ and SR; finally, evaluating the diagnostic efficiency. The final results were decided by pathological results (excision biopsy or operation) that are regarded as the gold standard for diagnosis, respectively evaluating the diagnosis rate and accuracy of conventional ultrasound, CE and ARFI which come from the differential diagnosis of benign and malignant breast tumors, and then comparing three kinds of ultrasonic technology in the differential diagnosis of breast tumor efficiency.Results The accuracy, sensitivity and specificity of CUS in the diagnosis of benign and malignant breast tumors are81.1%,81.7%,80%respective.The average values of SR of benign and malignant group are6.20±10.56,28.71±21.57, there is a significant difference between the two groups (P<0.05), When the SR truncation points is3.71, the sensitivity, specificity, accuracy, Youden index and AUC in diagnosis of malignant breast tumor are97.1%,83.3%,88.4%,80.4%,91.6%; The average values of VTQ of benign and malignant group are (2.86±0.82) m/s,(5.33±1.37) m/s, there is a significant difference between the two groups (P<0.05), When the VTQ truncation points is3.78m/s, the sensitivity, specificity, accuracy, Youden index and AUC in diagnosis of malignant breast tumor are94.3%,91.7%,92.6%,86.0%,92.0%.Conclusions Conventional ultrasonic, CE and ARFI have some value of clinical application for the differential diagnosis of breast cancer. But the diagnosis efficiency of ARFI is superior to CE and conventional ultrasound in differential diagnosis of benign and malignant breast tumor. We can draw on each technology to improve the rate of diagnosis of breast tumors. There are totally5figures,5tables and23references.