Objective To investigate the diagnostic value of strain elastic imaging and shear wave elastic imaging combined with breast imaging reporting and data system(BI-RADS)in benign and malignant breast masses.Methods The clinico-pathological data of 105 patients with breast masses(105 lesions in total)admitted to our hospital from April 2021 to March 2023 were reviewed.Preoperatively,they underwent routine ultrasonography,strain elastography,and shear wave elastogra-phy.The lesions were classified into benign and malignant groups using the pathological findings as the gold standard.Elas-tic strain ratio(SR),and shear wave maximum elastic modulus value(Emax)were compared between the two groups.The efficacy of BI-RADS,SR,Emax,and the combined diagnosis of malignancy of breast masses was evaluated by plotting the working characteristic ROC curves of the subjects.Results A total of 105 breast masses were examined pathologically showing 41(39.05％)malignant and 64(60.95％)benign masses.BI-RADS classification showed 10 cases in category 2,16 cases in category 3,21 cases in category 4a,19 cases in category 4b,18 cases in category 4c,and 21 cases in category 5.With a diagnosis of malignancy at 4b classification and above,the sensitivity of the BI-RADS classification for diagnosing malignant breast masses was 92.68％and the specificity was 68.75％.The SR and Emax values were higher in the malig-nant group than in the benign group(P＜0.05).ROC curve analysis showed that the AUCs of SR and Emax for diagnosing malignant breast masses were 0.739 and 0.784,and the optimal cut-off values were 4.17％and 98.21 kPa,respectively,and the AUCs of SR+Emax combined diagnosis were 0.861,with a sensitivity of 70.73％and a specificity of 92.19％,and a Yoden index of 0.629,which showed that the efficacy of the combination was higher than that of the single diagnosis(P＜0.05).ROC curve analysis showed that the AUCs of SR+BI-RADS,Emax+BI-RADS,and SR+Emax+BI-RADS for diag-nosing malignant breast masses were 0.826,0.830,and 0.892,respectively,and the diagnostic efficacy of SR+Emax+BI-RADS was higher than that of SR+BI-RADS,Emax+BI-RADS,and BI-RADS(P＜0.05).Conclusion The combined di-agnosis of SR+Emax+BI-RADS can significantly improve the diagnostic efficacy of breast cancer,and improve the specifici-ty of BI-RADS classification diagnosis.
Real-time tissue elastographyShear wave elastographyBreast imaging reporting and data systemBreast massDiagnosis
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