Comparative Study Of Automatic Breast Volume Scanner And Mammography In The Diagnosis Of Breast Disease With Microcalcification

Objective: To analyze the ultrasonographic features of automatic breast volume scanner(ABVS)corresponding to lesions with only microcalcification and no other abnormalities on mammography,explore the factors influencing the detection of ABVS microcalcification and analyze the correlation between ABVS characteristics and pathology.Compare the application value of ABVS and mammography in the diagnosis of microcalcification and improve the detection rate and diagnostic rate of microcalcification.Data and Methods: The patients who underwent breast surgery in our hospital from June 2018 to October 2020,which underwent mammography and ABVS examination retrospectively before operation and had complete surgical and pathological data were collected.Preoperative mammography showed only microcalcification and no other abnormalities.There were 90 lesions in 83 patients,of which 78 were single lesion and 6 were double lesions.The average age of the patients was 48 years old.Before operation,patients were examined by mammography and ABVS respectively,and the interval between them was no more than 1 month.On the premise of not knowing the pathological results,the ABVS sonographic features of corresponding parts of mammography microcalcification were retrospectively searched in ultrasonic workstation through the calcification information mammography.The ABVS images corresponding to the microcalcification region of mammography were classified as :ABVS found calcification: including 1.Calcification with mass;2.Calcification with ductal changes;3.Calcification only.No calcification in ABVS: 1.No abnormality;2.No calcification,but ABVS found abnormal sonogram(mass or duct change),and record the diameter of lesions on ABVS sonogram,and observe whether there is convergence sign on the coronal plane of ABVS.Objective to explore the factors affecting the Microcalcification detection of ABVS,analyze the correlation between the characteristics of ABVS and pathology,and then take the pathological results as the gold standard for diagnosis,and obtain and compare the area under curve(AUC)and sensitivity and specificity of ABVS and mammography in the diagnosis of Breast Disease with Microcalcification.Research Result:1.ABVS can show four distribution patterns of microcalcification: scattered distribution,cluster distribution,distribution along the ducts,and attached to the duct walls.When the mammography calcification was segmental,the corresponding calcification distribution on ABVS was mostly along the ductus.ABVS on the morphological display of microcalcification,it showed dot or gravel strong echo or bright spot,which could not distinguish the morphological differences of each calcification in detail.2.The detection rate of ABVS calcification was not affected by the age of patients,the type of mammary gland,the shape and distribution of mammography microcalcification and the grade of mammography.The detection rate of microcalcification in breast malignant lesions by ABVS was higher(55.8% vs 87.2%),and the difference was statistically significant(P<0.05).3.The lesion size of mammography simple microcalcification on ABVS was related to benign and malignant.When the mammography showed simple calcification and the lesions on ABVS were more than 2cm,the malignant possibility was higher(P<0.05).The convergence sign on ABVS images was statistically significant in the diagnosis of benign and malignant lesions of mammography microcalcification(P<0.001).4.Compared with DCIS,IDC was more likely to show calcification with mass(76.0% vs 24.0%)in ABVS ultrasound images,while DCIS was more likely to show calcification with ductal changes(62.5% vs 37.5%),and the difference was statistically significant(P<0.05).IDC was more likely to find convergence signs in the coronal plane,while DCIS was more likely to show cluster calcification in the coronal plane.5.The sensitivity and specificity of ABVS and mammography in the diagnosis of benign and malignant microcalcification lesions were ABVS: 85.1% and 77.4%;while mammography: 72.3% and 55.8% respectively.ABVS can accurately judge the benign and malignant lesions of simple microcalcification in mammography,and the sensitivity and specificity are higher than mammography.ROC curve showed the AUC of ultrasound and mammography in the diagnosis of benign and malignant microcalcifications were 0.798 and 0.652,respectively,and the difference was statistically significant(z=2.004,P=0.045).Conclusion:When the lesions of mammography are simple microcalcifications,it is difficult to distinguish benign from malignant by the characteristics of microcalcification.ABVS plays an important role in displaying the spatial anatomical relationship,showing the mass and duct changes.It can identify the specific location,size and coronal morphology of the lesions,improve the diagnosis of benign and malignant microcalcification.The detection rate of microcalcification in ABVS was only related to the pathological benign and malignant.The age of patients,the type of glands,the shape and distribution of microcalcification on mammography and the grade of mammography did not affect the detection of microcalcification by ABVS.The detection rate of ABVS for microcalcification without abnormal echo on sonogram is low,and the display of microcalcification morphology needs to be improved.Ultrasound is superior to mammography in the diagnosis of breast microcalcifications.It can provide more reference information for microcalcification lesions,and is a necessary examination method for the diagnosis of microcalcification lesions.