Published online Jun 26, 2020. doi: 10.12998/wjcc.v8.i12.2510
Peer-review started: February 24, 2020
First decision: March 24, 2020
Revised: April 9, 2020
Accepted: April 24, 2020
Article in press: April 24, 2020
Published online: June 26, 2020
Processing time: 121 Days and 2.4 Hours
The diagnostic specificity of conventional ultrasound for breast non-mass lesions (NMLs) is low at approximately 21%-43%. Shear wave elastography (SWE) can distinguish benign from malignant lesions by evaluating the internal and peripheral stiffness. SWE has good reproducibility and high diagnostic efficacy. However, there are very few independent studies on the diagnostic value of SWE in breast NMLs.
To determine the value of SWE in the differential diagnosis of breast NMLs.
This study enrolled a total of 118 patients with breast NMLs who underwent SWE examinations in the Beijing Shijitan Hospital Affiliated to Capital Medical University and The Second Hospital of Shandong University from January 2019 to January 2020. The internal elastic parameters of the lesions were recorded, including maximum (Emax), mean (Emean) and minimum elastic values and the standard deviation. The following peripheral parameters were noted: Presence of a “stiff rim” sign; Emax, and Emean elasticity values within 1 mm, 1.5 mm, 2 mm, 2.5 mm and 3 mm from the edge of NMLs. The receiver operating characteristic curve of each parameter was drawn, and the areas under the curve were calculated.
Emax, Emean and elastic values, and the standard deviation of the internal elastic values in malignant NMLs were significantly higher than those in benign NMLs (P < 0.05). The percentage with the “stiff rim” sign in malignant NMLs was significantly higher than that in the benign group (P < 0.05), and Emax and Emean at the shell of 1 mm, 1.5 mm, 2 mm, 2.5 mm and 3 mm in the malignant group were all higher than those in the benign group (P < 0.05). Of the surrounding elasticity values, Emax of the shell at 2.5 mm in malignant NMLs had maximum areas under the curve of 0.900, and the corresponding sensitivity and specificity were 94.57% and 85.86%, respectively.
The “stiff rim” sign and multiple quantitative elastic values within and around the lesion had good diagnostic performance in the differential diagnosis of breast NMLs. Emax in peripheral tissue had better diagnostic efficiency than other parameters.
Core tip: This study is the first to qualitatively and quantitatively analyze the stiffness in and around breast non-mass lesions. We found that the evaluation of stiffness around the breast non-mass lesions had a better differential diagnostic reference value.