The diagnostic value of real-time tissue elastography in differentiating benign and malignant breast tumors_West China Medical Journal

Authors：

 YI Fang ¹ , KANG Yu ² , ZHOU Tianzhi ¹

1. Department of Ultrasound, People’s Hospital of Guangan City, Guangan, Sichuan 638001, P. R. China;
2. Department of Ultrasound, Teaching Hospital of Chengdu University of T.C.M, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

YI Fang, Email: yifang111111@sina.com

Keywords：

Ultrasonography; Real-time tissue elastography; Ultrasonic elastography strain ratio; Breast diseases

DOI：

10.7507/1002-0179.201603009

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ObjectiveTo explore the value of ultrasound real-time tissue elastography in the differential diagnosis between benign and malignant breast lesions.Methods A total of 131 cases of patients with breast lesions who underwent ultrasound examination in the People’s Hospital of Guangan City between December 2010 and December 2015 were enrolled as the research object. The patients took conventional color Doppler ultrasound diagnosis firstly, and then took ultrasound real-time tissue elastography diagnosis. The lesions were scored with improved 5-scoring system respectively. By the strain ratio measure method equipped with the ultrasonic machine, strain ratio of the lesion was calculated, with 3.08 as the cut-off pont. The results were campared with the pathologic diagnosis.ResultsThere were 182 breast lumps in the 131 patients. The conventional ultrasound examination detected 128 benign lesions and 54 malignant lesions. By ultrasound real-time tissue elastography examination, there were 121 benign tumors and 61 malignant tumors. For the benign tumors, the elasticity imaging score was 1.74±0.81, and the elastic strain rate ratio was 1.83±1.22; for the malignant tumors, the elasticity imaging score was 4.45±0.59, and the elastic strain rate ratio was 8.68±5.58. The 182 breast lumps were all removed by surgical resection, and the pathologic examination showed there were 121 benign lesions and 61 malignant lesions. The accuracy, sensitivity and specificity of conventional ultrasonic diagnosis of breast malignant lesions was 76.4%, 59.0% and 85.1%, respectively; while the indexes of ultrasound real-time tissue elastography diagnosis of breast malignant lesions was 96.7%, 95.1% and 97.5%, respectively, and the differences were statistically significant (P<0.05).ConclusionReal-time tissue elastography is helpful in the differential diagnosis between malignant and benign breast lesions.

Citation： YI Fang, KANG Yu, ZHOU Tianzhi. The diagnostic value of real-time tissue elastography in differentiating benign and malignant breast tumors. West China Medical Journal, 2017, 32(7): 1046-1049. doi: 10.7507/1002-0179.201603009 Copy

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1. 罗葆明, 欧冰, 智慧, 等. 改良超声弹性成像评分标准在乳腺肿块鉴别诊断中的价值. 现代临床医学生物工程学杂志, 2006, 12(5): 396-398.
2. 智慧, 肖晓云, 杨海云, 等. 弹性应变率比值在乳腺实性肿物良恶性鉴别诊断中的价值初探. 中华超声影像学杂志, 2009, 18(7): 589-591.
3. Chen SC, Cheung YC, Su CH, et al. Analysis of sonographic features for the differentiation of benign and malignant breast tumors of different sizes. Ultrasound Obstet Gynecol, 2004, 23(2): 188-193.
4. Piñero A, Reus M, Illana J, et al. Palpable breast lesions: utility of Doppler sonography for diagnosis of malignancy. Breast, 2003, 12(4): 258-263.
5. Ophir J, Céspedes I, Ponnekanti H, et al. Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging, 1991, 13(2): 111-134.
6. Shiina T, Yamakawa M, Nitta N, et al. Recent progress of ultrasound elasticity imaging technology. International Congress Series, 2004, 1274: 59-63.
7. 罗建文, 白净. 弹性成像及其应用前景. 世界医疗器械, 2003, 9(6): 75-77.
8. 徐智章, 俞清. 医学超声的热点与新进展. 上海医学影像, 2003, 12(4): 306-308.
9. Krouskop TA, Wheeler TM, Kallel F, et al. Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging, 1998, 20(4): 260-274.
10. Shiina T, Doyley MM, BamberJC. Strain imaging using combined RF and envelope autocorrelation processing//Proceedings of the IEEE Ultrasonics Symposium.Savoy, Ⅲ: Institute of Electrical and Electronics Engineers Ultrasonics, Ferroelectrics, and Frequency Control Digital Archive, 1996: 1331-1336.
11. Waki K, Murayama N, Matsumura T, et al. Investigation of strain ratio using ultrasound elastography technique// Proceedings of ISICE 2007: the first international symposium on information and computer elements, 2007: 449-452.
12. Zhi H, Ou B, Luo BM, et al. Comparison of ultrasound elastography, mammography, and sonography in the diagnosis of solid breast lesions. J Ultrasound Med, 2007, 26(6): 807-815.
13. Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology, 2006, 239(2): 341-350.
14. 罗葆明, 欧冰, 冯霞, 等. 乳腺疾病实时组织弹性成像与病理对照的初步探讨. 中国超声医学杂志, 2005, 21(9): 662-664.
15. Hiltawsky KM, Krüger M, Starke C, et al. Freehand ultrasound elastography of breast lesions: clinical results. Ultrasound Med Biol, 2001, 27(11): 1461-1469.
16. 俞清, 王文平, 季正标, 等. 实时超声弹性成像评估物体硬度的实验研究. 中华超声影像学杂志, 2007, 16(11): 997-999.
17. 王怡, 王涌, 张希敏, 等. 组织弹性成像鉴别乳腺良恶性肿块的价值评估. 中国医学影像技术, 2005, 21(11): 1704-1706.

West China Medical Journal

The diagnostic value of real-time tissue elastography in differentiating benign and malignant breast tumors

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