Study On The Value Of Differential Diagnosis Of Benign And Malignant Breast Masses By Conventional Ultrasound Combined With The Elastic Imaging

ObjectiveTo evaluate the value of differential diagnosis of benign and malignant breast masses by conventional ultrasound combined with elasticity imaging score.Materials and MethodsA total of 98 female patients with 106 breast masses, including 60 benign,46 malignant, were researched during January 2012 to June 2013 in Tongling People’s Hospital, including outpatient and inpatient treatment. All the masses maximum diameter of 10～ 35mm, average diameter Of (20±0.5) mm, were confirmed by the postoperative pathological results. The use of the instrument was Philips IU-22 color Doppler ultrasonic diagnostic apparatus. All the masses were firstly examined by using conventional ultrasound, observed the two-dimensional ultrasound information and information of blood flow. Secondly, they were examined by using ultrasound elasticity imaging for hardness score. Finally, they are examined by the combination of the two inspection, constructed the receiver operating characteristic (ROC) curve and calculated the area under the curve (AUC) of three methods of inspection. Judged the benign and malignant of all masses, respectively, compared with the postoperative pathological results, and compared the sensitivity, specificity and accuracy of the three methods in diagnosis of benign and malignant breast masses.Results1. The sensitivity, specificity and accuracy of diagnosis of benign and malignant breast masses by using conventional ultrasound were 73.91%(34/46),86.67 (52/60) and 81.13 (86/106).2. The ultrasound elasticity score more than 4 points as the boundary points to sentenced to be malignancy. The sensitivity, specificity and accuracy of diagnosis of benign and malignant breast masses by using the ultrasonic elastic scoring method were 76.09%(35/46),88.33%(53/60) and 83.02%(88/106).3. There were 53 masses with elasticity score from 1 to 3 points in benign group, accounting for 88.33%, and the average score was 1.95 ± 1.06. There were 35 masses with elasticity score from 4 to 5 points in malignant group, accounting for 76.09%, and the average score was 4.02±0.95. There was statistical significant difference in scoring between the two groups (<0.05).4. The sensitivity, specificity and accuracy of diagnosis of benign and malignant breast masses by using conventional ultrasound combined with ultrasonic elastic scoring (combined usage) were 93.48%(43/46),88.33 (53/60) and 90.57 (96/106).5. The difference of sensitivity, specificity and accuracy of above three methods in diagnosis of benign and malignant breast masses was compared. The sensitivity and accuracy of combined usage diagnosis were higher than that of conventional ultrasound or elastic scoring diagnosis alone (p<0.05), there was statistical significance, but there was no significant difference in the diagnostic specificity was found among the three groups (p>0.05).6. The data of AUC by using conventional ultrasound, ultrasound elasticity imaging, combined usage were 0.803,0.822 and 0.909, which were between 0.8-1.0, and the data of combined usage was significantly higher than that of conventional ultrasound and elastic score (p<0.05).ConclusionsUsing conventional ultrasound, ultrasound elastic scoring and combined usage to diagnose benign and malignant breast masses all have a certain diagnostic value. But the combined usage method can improve the sensitivity and accuracy of diagnosis of benign and malignant breast masses, and then can improve the ability of differential diagnosis.