The Application Research Of Zone Speed Index Technique In The Diagnosis Of Breast Lesions

Objectives1To explore the stability and related factors of breast lesions by zone speedindex technique on the clinical application.2To explore the clinical value of the zonespeed index technique for the differential diagnosis of breast benign and malignantlesions.Methods149patients with the symptoms of painless breast lumps, bloody nippledischarge, breast tingling, Orange-like changes in the breast were examined with grey-scale sonography, color Doppler ultrasound（CDUS）, and ZSI technique before surgeryon Hebei United University Affiliated Hospital. With surgical pathology diagnosis, breastlesions were151cases,36cases were malignant,115cases were benign. Simultaneouslymeasured the ZSI of149cases mammary gland which side was not sick. ZONAREultrasound system with the technology of ZSI was used in this study. The frequency of thelinear array probe (Type L10-5) was from5to10MHz. All patients were completed theconventional ultrasound, color Doppler ultrasound, ZSI technical operations before surgery,had finished the record of the size of each breast mass (and aspect ratio＞1or＜1), whetherregular or unregular shape, internal echo characteristics, with or without acousticattenuation in detail, then preserved the images of two-dimensional ultrasound, CDUS, andZSI technique at least four more. To reduce the deviation of measurement, measured zonespeed index technique six times to calculate the average of ZSI, then got SV (Soundvelocity) through the ZSI+1540cm/s. The SPSS13.0was used to analyze the data.Measurement data used mean±standard. The chi-square test was used to observe if thedifference of various methods was statistically significant. Using intraclass correlationcoefficient (ICC) evaluated the stability of ZSI six times. Correlation between twovariables by spearman rank correlation analysis, P＞0.05indicated not statisticalsignificance. Statistically significant differences between mean values, we used t test in theZSI between benign and malignant masses, P＜0.05indicated statistical significance. Thereceiver operating characteristic curve was drew, got AUC, and obtained the bestdiagnostic threshold values according to the clinical situation.Results1ZSI determination had a good stability, intraclass correlation coefficient (ICC)was0.98.2The correlation coefficient of ZSI of151breast masses to the subcutaneous layer thickness, glandular layer was0.018,0.165respectively. Glandular layer thickness P＜0.05, the difference was statistically significant, subcutaneous layer thickness no morethan（P＞0.05）.3The ZSI of benign breast lesions were26.79±14.13, and the ZSI ofmalignant breast lesions were46.67±24.59. There was significant difference between theZSI of benign and malignant lesions (t=-6.162， P＜0.05). The ZSI of malignant lesionswere bigger than the benign lesions.4With pathologic diagnosis as the gold standard,ROC curves（1-specificity was the abscissa, specificity was the ordinate）were obtainedto assess the performance of the different ZSI cutoff points. The AUC was0.866. The ZSIwas a good method for differentiating malignant and benign breast lesions.534.17m/s wasthe best cutoff point of the ZSI for distinguishing malignant from benign lesions. Itssensitivity was88.9％, and its specificity was75.7％.Conclusions1Zone speed index technique as a new technology could detect breastlesions quantitatively and had good stability.2Zone speed index could be used toprovide objective quantitative basis of benign and malignant breast lesions, and would beexpected to be an important index of clinical reference for differential diagnosis of breastlesions.3Cutoff point of the ZSI34.17m/s could improve higher sensitivity to detectbreast lesions, and would provide early diagnosis and treatment for clinic.