The Differential Diagnosis Value Of Conventional Ultrasonographyand Ultrasonic Elastography For Non-Lactation Mastitis And Breast Malignancy

Objective:To explore the differential diagnosis value of conventional Ultrasound and Ultrasonic Elastography (UE) for Non-lactating Mastitis (NLM) and breast malignancy.Method:The data was collected from Gastro-intestinal and Glandular Surgery Department of The First Affiliated Hospital Guangxi Medical University since October 2012 to August 2015. All patients were histologically diagnosed the non-lactating mastitis or breast malignancy by the operation or by fine-needle aspiration. Among 455 patients, there were 70 NLM and 385 breast malignancies. The clinical manifestation of patients, conventional Ultrasound and UE presentation of breast lesions were analyzed.Results:(1) Among 70 NLM patients,50 patients presented painless breast masses (50/70),12 patients presented breast mass with discharge and pain (12/70) and 8 patients presented acute inflammation (8/70).(2) The differences of lesions posterior echo attenuation, micro-calcification, grade II-III blood flow, RI<0.70 and UE grade 1-3 between NLM and breast malignancy group were statistically significant (P<0.05). (3) Most of NLM lesions involved the derma layer and subcutaneous fat (39/70). Part of NLM lesions presented hypoecho with inverted triangular shape (12/70). Slight tissue edema was showed around some NLM lesions (13/70). Nevertheless, all NLM lesions were not involved the muscular layer. (4) The NLM diagnostic consistency rate by high-frequency US, UE and high-frequency US combined with UE were 51.4%, 78.6% and 58.6%, respectively, and the difference among them was statistically significant (P<0.05). Nevertheless, the diagnostic accuracy rate of UE in NLM was higher than BI-RADS classification and corrected BI-RADS classificationConclusion:The NLM lesions may show the following performance:(1) mostly involve the derma layer and subcutaneous fat. (2)show hypoecho with inverted triangular shape. (3)are associated with edema of surrounding tissue. (4)present spotted or small strip shaped micro-calcification within the lesion. (5) present abundant blood flow within lesions, but most were low resistant blood flow signals with RI<0.70.(6)UE grade 1～3. corrected BI-RADS classification could not increase the diagnostic accuracy rate of NLM, but UE may be helpful in differential diagnosis of NLM from breast malignance.