| ObjectiveBI-RADS standard is an invaluable tool which is in good use of diagnosis with breast masses. It is used to evaluation of different nature of the masses mainly from external form. It is easily influenced by the diagnosis of doctors’ subjective judgment. Elastic strain ratio(SR) is a new semi quantitative index.This technique determine the tumor properties by contrast the internal strain rate difference between tumor and normal tissue. This research is to explore optimal points of SR in the check of breast masses with different nature.Compare the identify significance of SR with BI-RADS standard, then evaluate if uesing combination of both two methods can further improve the identify value of breast tumor.MethodsThe study included 94 patients, they are all women, 101 breast tumor were detected in using ordinary way. The lesions were scored with BI-RADS standard and SR respectively.The pathologic diagnosis was the gold standard.Constructed the subjects operating features(ROC) curve and determined the optimal points of SR in the confirm of malignant breast lesions. The confirm value includ the sensitivity, the specificity and the diagnosis correctness. Calculate three diagnostic value of SR、BI-RADS standard and the combination of the two. Compare the diagnostic value of three methods.Analysis the area under the curve of three methods.Results1. Make a determination about the optimal points in elastic strain ratioThe optimal points of elastic strain ratio was 3.03, judge mass as malignant if SR ≥ 3.03, diagnosed the tumor as benign if SR <3.03. The strain ratio of benign group was(1.96 ± 0.88),the malignant group was(4.74 ± 2.22),the two groups were compared with significant difference(P <0.01).2. Make a contrast to the identification significance between elastic strain ratio, BI-RADS standard and the combination about two methodsThe sensitivity of elastic SR was 92.3%, the specificity of it was 88.7%, the saccuracy of it was 90.1%. BI-RADS standard also has three diagnostic values in turn that were 71.8%、87.1% and 81.2%, the combination of the two own the sensitivity,specificity,accuracy of were 94.9%, 93.5% and 94.1%.Sensitivity of elastic strain ratio confirmed better than BI-RADS standard(P <0.05).There was no obvious different significance between the specificity and accuracy of the two methods(P>0.05).Sensitivity and correctness about the association between the two methods was confirmed higher than BI-RADS standard(P <0.05).3. Make a compare of three arc following areas contain with elastic strain ratio, BI-RADS standard and the combination with two methodsArea of ROC curve of BI-RADS standard was 0.841, the standard error was 0.045, 95%,confidence interval was 0.726~0.902. Area of ROC curve of elastic strain ratio is below 0.933, the standard error was 0.025, the 95% confidence interval was 0.884~0.981.Area of ROC curves of two combined was 0.931, the standard error is 0.030, 95% confidence interval was 0.871~0.990.The area below the curve of three methods were larger than the area below the reference line 0.5,the fact was difference between the two was very significant(P <0.05). It was confirmed that elastic strain ratio has larger area than BI-RADS standard(P <0.05), meanwhile the area under the curve of the combination of the two methods was larger than using BI-RADS standard only(P <0.05).Conclusion1. As a semi quantitative inspection method,the elastic strain ratio has more objective results. SR with 3.03 as the optimal point has a high identification significance, accurate specificity and excellent sensitivity just like BI-RADS standard.2. The elastic strain ratio ratio has higher diagnostic sensitivity than BI-RADS standard. It can help identify malignant tumors from kinds of masses efficiently.3. The elastic strain ratio combined with the BI-RADS standard diagnostic method is very efficient,it can further inform the diagnosis significance of breast masses. |
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