Ultrasonic Elastography Combined With Sound Speed Correction Technique In Breast Space Occupying Lesions Diagnostic Value

Objectives To evaluate the clinical value of sound speed correction technique in the differential diagnosis between the benign and malignant breast neoplasm, and to find out the threshold of sound velocity and related factors of benign and malignant breast neoplasm. To compare the diagnostic value of the elastic score evaluation method and strain ratio method in the differential diagnosis of benign and malignant breast neoplasm.To combine sound speed correction technique and ultrasonic elastography in diagnosis of breast benign and malignant neoplasm. To explore the consistency of the two technologies with pathological diagnosis. Thus, there would provide reliable basis to ultrasonography in the breast neoplasm clinical diagnosis.Methods One hundred and fifty female patients were collected who had taken surgery or biopsy in Affiliated Hospital of North China University of Science and Technology from September 2014 to July 2015. One hundred and sixty breast tumor(100 benign, 60malignant) of the patients were included in the study. First of all, routine ultrasound examination of breast tumorwas made to make records of routine ultrasonography of breast tumor. And the breast tumor were examined by sound speed correction technique to calculate the sound velocity, recording the depth of the breast neoplasm, breast subcutaneous fat layer thickness and the thickness of mammary glands. Then the breast tumor were checked with real time ultrasonic elastography to obtain the elastic image of breast neoplasm. Elastic image of breast tumor was used by the elastic score evaluation method and strain ratio method, which were taken to judge the breast tumor benign and malignant. Finally, combined real time ultrasonic elastography and sound speed correction technique was taken to identify the benign and malignant breast neoplasm.A database was built in Excel 2007, and SPSS 17.0 statistical analysis software was used for statistical analysis. All normal distribution of measurement data as mean ±standard deviation( sx ±) was taken. The means comparison between the two groups was used Independent-Samples T test( There was statistical significance as P<0.05). The chi-square test was used with frequency comparison. The stability of ZSI in six times was evaluated with ICC. Compared with the pathological diagnosis, the threshold of sound velocity was determined by the ROC curve and the clinical practice. Kappa consistency test was used to evaluate the consistency of ound speed correction technique, elastic score evaluation method, strain ratio method, sound speed correction technique combined with strain ratio compared with the golden standard.Results 1 The comparison result of basic clinical data:(1)There were one hundred case of benign breast tumor and sixty case of malignant breast tumor among the result of one hundred and sixty breast tumor pathology.(2)Benign breast tumor patients were younger than the patients with malignant breast tumor. Benign breast tumor maximum diameter was smaller than the maximum diameter of malignant breast tumor. 2 The comparison result of related indicators with sound speed correction technique:(1)ZSI of the breast neoplasm had good stability, ICC was 0.92.(2)Malignant breast tumor sound velocity was faster than the sound velocity of benign breast tumor. There was significant difference of sound velocity between the benign and malignant breast neoplasm(t=-13.34,P<0.05). The area of ROC curve was 0.918. Youden index was 0.74. 1535.83m/s was the threshold of sound velocity determined by the ROC curve and the clinical practice.(3)There was no difference of sound velocity between different breast subcutaneous fat layer thickness and thickness of mammary glands. There was significant difference between sound velocity in different depth in the benign group(t=2.90, P<0.05). There was no significant difference between sound velocity in different depth in the malignant group(t=-0.10, P>0.05). 3 The comparison result of related indicators with ultrasonic elastography technique:(1)The results of the elastic score evaluation method and strain ratio method in the diagnosis of benign and malignant breast neoplasm were not significantly different(?2=0.04, P>0.05).(2)While elastic score evaluation method was taken to identify the benign and malignant breast neoplasm, the sensitivity and specificity were 67.9%, 91.9% respectively. Also strain ratio method was taken to identify the benign and malignant breast neoplasm, the sensitivity and specificity were 71.6%, 95.9%respectively. Two elastic methods had good consistency in pathological results. Kappa of the elastic score evaluation method was 0.623. Kappa of strain ratio method was 0.711. 4The sensitivity was 94.3%, specificity was 78.7%, and Kappa was 0.678, which sound speed correction technique combined with strain ratio were taken to identify the benign and malignant breast neoplasm.Conclusions 1 Malignant breast sound velocity was faster than the maximum diameter of Benign breast tumor. 2 The depth of the breast neoplasm has effect on the sound velocity. 3 Ultrasonic elastography technique by analyzing the hardness of the breast tumor to determine its benign and malignant. The hardness of malignant breast tumor is higher than the hardness of benign breast tumor. The elastic score evaluation method and the strain ratio method provided a sound basis in the diagnosis of benign and malignant breast neoplasm. 3 With combination of sound speed correction technique and strain ratio in the diagnosis of benign and malignant breast neoplasm, the sensitivity was increased,and misdiagnosis could be avoided.