The Application Research Of Ultrasound Compression Elastography(UE) And Virtual Touch Tissue Quantification(VTQ)in The Differential Ddiagnosis Of Benign And Malignant Breast Masses

Objective: To explore the value of ultrasound compression elastography(UE)and virtual touch tissue quantification(VTQ)in benign and malignant breast masses.Methods: From March 2018 to December 2018,101 patients in our hospital were diagnosed with a total of 118 breast masses by pathological confirmation after surgery or biopsy.These patients are 25-82 years old,with an average age of 43.56±4.63.Using Siemens ACOUSON S2000 ultrasonic instrument equipped with 9L4 high frequency Probe with a frequency of 4MHz~9MHz,elastography software,and virtual touch quantification software,all the masses included in the study are inspected by conventional ultrasonography,UE and VTQ to obtain 2D grayscale and color doppler sonograms,elastic images,and VTQ values.The inspection images are stored and the inspection data is recorded.The elastic images are scored according to Luo Baoming's improved five score method;the receiver operator characteristic(ROC)curve is drawn to obtain the best cutoff point of the VTQ values.With Pathological results as the golden diagnostic standard,the sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of conventional ultrasonography,UE,VTQ and the combination of the three in diagnosing benign and malignant breast masses are calculated and comparison,and the advantages and disadvantages of these diagnosis methods are analyzed.Results: 1.Pathological examination of 118 breast masses showed that 56 were malignant and 62 were benign.2.The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of conventional ultrasonography in diagnosing benign and malignant breast masses are 96.43%,62.90%,78.81%,70.13% and 95.12% respectively.3.The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of UE in diagnosing benign and malignant breast masses are 75.00%,79.03%,77.12%,76.36% and 77.78% respectively.4.In benign masses,the mean value of VTQ is 2.64±1.05,and the VTQ value is in the range of 1.04-5.89.In malignant masses,the mean value of VTQ is 6.06±1.98,and the VTQ value is in the range of 1.32-9.00.The difference between the two groups is statistically significant(P<0.05).The ROC curve is used to obtain the VTQ value for identifying benign and malignant lesions,and its value of area under the curve(AUC)is 0.917 and its 95% CI is 0.852-0.960.When the Yoden index reaches the maximum of 0.780,the corresponding VTQ cutoff point is 3.895 m/s,i.e.?3.895 means malignant and <3.895 means benign.The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of VTQ in diagnosing benign and malignant breast masses are 89.29%,88.71%,88.98%,87.72% and 90.16% respectively.5.The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of the combined use of conventional ultrasonography + UE + VTQ in diagnosing benign and malignant breast masses are 92.86%,91.94%,92.37%,91.23% and 93.44% respectively.6.The diagnostic efficacies of different inspection methods are compared.The accuracy rate of the combined diagnosis is higher than that of conventional ultrasonography,UE and VTQ,and the difference between the combined diagnosis and conventional ultrasonography and UE is statistically significant(P<0.05).The statistical indicators of VTQ are higher than those of UE,and the difference between the accuracy rate and the sensitivity is statistically significant(P<0.05).The specificity of UE is higher than that of conventional ultrasonography,and the difference is statistically significant(P<0.05).The accuracy rate and specificity of VTQ are higher than those of conventional ultrasonography,and the difference is statistically significant(P<0.05).Conclusion:(1)The difference in hardness between benign and malignant masses is significant.(2)Both ultrasound elastography(UE)and virtual touch quantification(VTQ)are of important diagnostic value in identifying benign and malignant breast masses.(3)As a quantitative evaluation method,VTQ's overall evaluated efficacy is higher than that of ultrasonic elastography(UE).(4)Ultrasound elastography(UE)and Virtual touch quantification(VTQ)are usef ulsupplements for conventional ultrasonography.Combined with conventional ultra sonography,UE and VTQ can improve the efficacy of the differential diagnosis of benign and malignant breast masses.