Abstract：Objective: To explore the value of shear wave elastography (SWE) combined with breast imaging reporting and data system (BI-RADS) grading in the differential diagnosis of breast masses and its relationship with pathological features. Methods: 96 patients with breast masses were examined by conventional breast ultrasonography and SWE, and the BI-RADS grading and modified SWE scoring were performed. With the diagnostic results of pathology as the golden standard, the diagnostic efficiency of BI-RADS grading and its combination with SWE in the differential diagnosis of breast masses was evaluated by the area under receiver operating characteristic (ROC) curve (AUC). The strain ratio of ultrasonic elastography of normal tissues and mass tissues was measured by SWE, and its relationship with pathological features was analyzed. Results: In the 96 patients, there were benign and malignant masses in 67 cases and 29 cases respectively diagnosed by pathology. There were statistically significant differences of BI-RADS grade and SWE score between benign and malignant masses (P < 0.05). The ROC curve showed that the AUC of BI-RADS grading and SWE combined with BI-RADS grading in the differential diagnosis of breast masses were 0.83 and 0.91 respectively. The specificity, positive predictive value, negative predictive value of SWE combined with BI-RADS grading in the diagnosis of benign and malignant breast masses were significantly higher than those of BI-RADS grading alone. In the 96 patients, the strain ratio of ultrasonic elastography was lower than 3.08 in 68 cases and more than 3.08 in 28 cases, with statistically significant differences between the two in the shape of masses, boundary, aspect ratio, echo, calcification, blood flow and other pathological features (P < 0.05). Logistic regression and multivariate analysis showed that shape of masses, boundary, aspect ratio, echo, calcification and blood flow were independent influencing factors of elasticity strain ratio larger than 3.08 (P < 0.05). Conclusion: SWE combined with BI-RADS grading can fully display the histological and pathological features of breast masses, which is helpful for the differential diagnosis of benign and malignant breast masses.
袁长翮, 魏杰. SWE结合BI-RADS分级对乳腺肿块鉴别诊断价值及其与病理特征关系的研究[J]. 河北医学, 2018, 24(3): 366-370.
YUAN Changhe, WEI Jie. The Value of SWE Combined with BI-RADS Grading in the Differential Diagnosis of Breast Masses and the Relationship with Pathological Features. HeBei Med, 2018, 24(3): 366-370.
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2018, Vol. 24 
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