The Value Of Shear Wave Elastography In The Diagnosis Of Breast Cancer

Objective: To evaluate the value of shear wave elasticity imaging techniques in the diagnosis of breast tumor.Materials and methods: 98 patients(108 lesions) were collected from December 2013 to December 2014 in Tianjin Medical university cancer institute and hospital and Tianjin huanghe hospital for breast ultrasound examination of patients, of all lesions underwent conventional 2D, 3D ultrasound and two based on the shear wave elastography ultrasound images, all according to Breast Imaging Reporting and Data Syatem(BI-RADS) of the ultrasound diagnosis standard were analyzed, including categories 0-4A lesions of benign lesions, categories 4B-5 of the diagnosis of malignant. the maximum modulus of elasticity under the condition of two-dimensional and three-dimensional SWE lesions(max), the minimum value of the elastic modulus(min), the average elastic modulus(mean) were measured. All lesions were confirmed by operation or biopsy pathology results. All analyses were performed by using software(SPSS, version 17.0), with P<0.05 considered to indicate a significant difference. Two independent samples were compared using the test, the corresponding critical value in diagnosis of ROC curve analysis of the elastic modulus and the diagnostic efficacy of lesions of benign and malignant breast lesions, the average elastic modulus maximum value. In the χ2 test analysis of differences between the two dimensional ultrasound and two-dimensional SWE, 3D SWE and 2D, 3D ultrasound combined with 2D SWE, 3D SWE in diagnosis of breast benign and malignant lesions of sensitivity, specificity and accuracy, the difference was statistically significant. Comparison of two dimensional ultrasound combined with 2D SWE, 3D ultrasound and 3D SWE in diagnosis of breast cancer, the sensitivity, specificity and accuracy of the difference, the diagnostic criteria: when one of the two methods in a positive, positive diagnosis; when one of the two methods were negative, the diagnosis was negative.Results:108 breast lesions in 98 patients, 40 benign and 68 malignant lesions. The sensitivity of conventional two-dimensional ultrasound in the diagnosis of breast cancer was 88.2%, the specificity was 85.0%, accuracy was 87.0%.Two dimensional SWE maximum modulus of elasticity of malignant lesions,elastic modulus,average value of minimum elastic modulus values were(155.58+30.76) k Pa,(46.82+18.54) k Pa and(14.25+11.68) k Pa;two-dimensional SWE maximum elastic modulus of benign lesions,elastic modulus,average value of minimum elastic modulus values were(40.48 +9.07) k Pa,(24.88+6.51) k Pa and(11.77+4.22) k Pa.Three dimensional SWE maximum elastic modulus of malignant lesions of the value,the average elastic modulus values were(172.69+58.04) k Pa and(63.87+30.65) k Pa;3D SWE maximum elastic modulus of benign lesions of the value,the average elastic modulus values were(70.60+57.57) k Pa and(40.27+16.75) k Pa.Compared the two dimensional SWE lesions and SWE between 3D elastic average and maximum values of the differences were statistically significant(P<0.01),the minimum value of the differences were not statistically significant(P >0.05).The accuracy rate is better than that of SWE elastic elastic maximum evaluation of breast benign and malignant lesions of average value, the difference was statistically significant(P<0.05). Under the ROC curve of SWE in two-dimensional elastic maximum value of 98.82 k Pa as a diagnostic threshold, the sensitivity was 89.5%, specificity was 95.3%, accuracy was 92.7%; the average value of elasticity with 43.88 k Pa as the diagnostic critical value, the sensitivity was 82.1%, specificity was 95.7%, accuracy was 87.8%. Under the ROC curve of SWE in three dimensional elastic maximum value of 102.54 k Pa as a diagnostic threshold, the sensitivity was 86.3%, specificity was 83.9%, accuracy was 85.1%; the average value of the elasticity of 53.87 k Pa as a diagnostic threshold, the sensitivity of diagnosis was 73.8%, the specificity was 91.1%, accuracy was 80.4%. The specificity, accuracy of two dimensional SWE in the diagnosis of breast cancer were compared with two-dimensional ultrasound and three-dimensional SWE, the difference was statistically significant(P<0.05).Two dimensional ultrasound combined with 2D SWE elastic maximum sensitivity in diagnosis of benign and malignant breast lesions was 97.1%(66/68), the specificity was 92.5%(37/40), the accuracy was 95.4%(103/108); three dimensionalultrasound combined with three-dimensional SWE elastic maximum sensitivity in the diagnosis of benign and malignant breast lesions was 89.7%(61/68), the specificity was 90.0%(36/40), the accuracy was 89.8%(97/108). The sensitivity and accuracy of two-dimensional ultrasound combined with 2D SWE in the diagnosis of breast cancer with three-dimensional ultrasound combined with three-dimensional SWE comparison, the difference was statistically significant(P<0.05).Conclusion: ①SWE provides more information in the diagnosis of breast ultrasound. The quantitative elasticity modulus maximum and average value in the diagnosis of breast diseases is higher than that of the elastic modulus of the minimum value. When the two dimensional SWE elastic modulus maximum value exceeds the average value of 98.82 k Pa or more than 43.88 k Pa, with high malignant tumor specificity and diagnostic accuracy. Three dimensional SWE elastic modulus maximum value more than 102.54 k Pa or the average of more than 53.87 k Pa, the diagnosis of breast malignant lesions. Shear wave elastography of breast malignant lesions were significantly higher than those in benign lesions. ② Lesions under the condition of three dimensional wave shear elastic modulus maximum value, based on average than the 2D condition. ③ This is the first study to compare the value of two-dimensional,three-dimensional ultrasound combined with SWE examination in diagnosis of benign and malignant breast lesions, two-dimensional SWE diagnostic efficiency is higher than that of the three-dimensional SWE, the diagnostic performance of dimensional ultrasound and two-dimensional SWE is higher than that of three dimensional ultrasound combined with three-dimensional SWE.