Objective To compare the difference of elastic measurement of breast lesions between ultrasound gel pad and coupling agent assisted shear wave elastography(SWE),and to explore the efficacy of ultrasound gel pad in improving the stability of SWE measurement in breast lesions.Methods A total of 147 patients with pathologically confirmed breast lesions were selected,all of which were single lesions,including 91 cases of benign and 56 cases of malignant.SWE measurement of breast lesions was performed by the same operator with the aid of coupling agent(coupling agent group)and ultrasound gel pad(ultrasound gel pad group).The maximum value(Emax),mean value(Emean),minimum value(Emin)and standard deviation(Esd)of Young's modulus were compared between the two groups.The consistency of repeatability measurements between the two groups of operators was analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of SWE parameters of two groups for differentiating benign and malignant breast lesions.The consistency of the diagnostic results obtained by the two different methods and the pathological results was analyzed.Results The Emax,Emean,Emin and Esd in the ultrasound gel pad group were lower than those in the coupler group,the differences were statistically significant(all P<0.001).The consistency of Emax,Emean and Esd in the ultrasound gel pad group was very good(ICC=0.886,0.825,0.774,all P<0.001),and the consistency of Emin was good(ICC=0.613,P<0.001).The consistency of Emax,Emean,Emin and Esd in the coupling agent group was good(ICC=0.733,0.405,0.578,0.728,all P<0.001).The Emax,Emean and Esd of malignant lesions were higher than those of benign lesions in the coupling agent group and ultrasound gel pad group,and Emin of malignant lesions were lower than that of benign lesions,the differences were statistically significant(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of Emax in differentiating benign and malignant breast lesions was the highest in the coupling agent group(0.774),and the sensitivity and specificity were 82.14%and 68.13%,respectively.The AUC of Emax in differentiating benign and malignant breast lesions was the highest in ultrasound gel pad group(0.910),and the sensitivity and specificity were 87.50%and 86.81%,respectively.The AUC,sensitivity and specificity of Emax in differentiating benign and malignant breast lesions were higher in the ultrasound gel pad group than those in the coupling agent group,the differences were statistically significant(all P<0.05).The diagnostic results of Emax in differentiating benign and malignant breast lesions were consistent with pathological results in the ultrasound gel pad group(Kappa=0.717,P<0.05),while the diagnostic results of Emax in differentiating benign and malignant breast lesions were consistent with pathological results in the coupling agent group(Kappa=0.460,P<0.05).Conclusion The application of ultrasound gel pad can improve the stability of SWE measurement,and it has a certain clinical application value in the differential diagnosis of benign and malignant breast lesions.
UltrasonographyShear wave elastographyBreast lesions,benign and malignantUltrasound gel padCoupling agent
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