Diagnostic Value Of Strain Ratio Method And Improved5-scoring System In Differentiating Breast Benign And Malignant Lesions With Ultrasonic Elastography

Objective:To explore and compare the diagnostic value of strain ratio method and improved-5scoring system in differentiating benign and malignant lesions of breast.Materials and methods:130patients （all female） with breast lesions were underwent ultrasonicelastography(UE) examination, and obtained UE image when image stabilization. By colordistribution analysis of focal region, UE image were scored with improved-5scoringsystem. Strain ratio(SR) indexes of lesions were calculated. Repeating more than2~3timesand taking the average of SR. Two aspects of the results were compared with thepathological findings. Described the receiver operating characteristic (ROC) curve of twomethods, identified the cut-off point for differentiating benign and malignant lesions ofbreast, and the diagnostic value of two methods were compared.Results:(1)A total of155lesions of breast in130patients were120benign and35malignantlesions. The strain ratio（SR） index of breast benign lesions was1.82±0.83, which wassignificantly different from the value of malignant lesions3.93±1.06(t=-4.339, P <0.05).(2) Using ROC curve plotting obtained3.05as the cut-off point of SR index fordifferentiating breast benign and malignant lesions, the sensitivity, specificity, accuracy,positive predictive value and negative predictive value were85.7%(30/35),94.1%(113/120),92.2%(143/155),81.0%(30/37) and95.8%(113/118),respectively. Whilethe sensitivity, specificity, accuracy, positive predictive value and negative predictivevalue were80.0%(28/35),93.3%(112/120),90.3%(140/155),77.8%(28/36) and94.1%(112/119), respectively, in differential diagnosis of breast benign and malignantlesions by improved-5scoring system. (3) The area under the curve(AUC) of strain ratio method was0.93,and the AUC ofimproved-5scoring system was0.89,the difference between two aspects was no significant(Z=0.88, P>0.05).(4) Compared the sensitivity, specificity, accuracy, positive predictive value andnegative predictive value of strain ratio method and improved-5scoring system,respectively, the difference between them was no significant (P>0.05).Conclusion:The elastic SR of breast malignant lesions is higher than benign ones. With3.05asthe cut-off point of SR, it was valuable for differentiating breast benign and malignantlesions. SR indexes as well as improved-5scoring system was valuable in differentialdiagnosis of breast benign and malignant lesions. It could obtain a semi-quantitative index,and SR method was more practical in differential diagnosis of breast benign and malignantlesions.