Application of shear wave elastography combined with superb micro-vascular imaging in diagnosing benign and malignant breast solid masses

Objective To investigate the application value of shear wave elastography (SWE) combined with superb micro-vascular imaging (SMI) in differentiating malignant and benign breast masses. Methods Seventy-two patients diagnosed by ultrasound and verified with postoperative pathological analysis were selected. There were total 86 masses including 42 benign and 44 malignant masses. After two-dimensional ultrasonography, SWE and SMI were performed to evaluate the elasticity and micro-vascular status in breast masses. ROC curve was drawn to calculate the sensibility and specificity. SMI was used as the reference to calculate the sensitivity and specificity of SWE combined with SMI in differentiating malignant and benign breast masses. Results ①There was no significant difference in the maximum diameter between two groups. ②The Young′s modulus (AveT1), the ratio between fat and mass (Ratio1) and SMI values between malignant and benign groups were all significantly different (P<0.01). ③The 56.75 kPa was used as the best cut-off value of AveT1, the area under the ROC curve was 0.917 with sensitivity 81.8% and specificity 85.7%. ④The 4.13 was used as the best cut-off value of Ratio1, the area under the ROC curve was 0.819 with sensitivity 90.9% and specificity 77.7%. ⑤SWE combined with SMI reduced the misdiagnosis rate from 9.52% of SWE only to 4.76% with sensitivity 93.18% and specificity 92.23%. Conclusions SWE combined with SMI represents excellent application value in differentiating malignant and benign breast masses, which can reduce the misdiagnosis rate effectively and promote the sensitivity and specificity of diagnosis. Key words: Elasticity imaging techniques; Breast neoplasms; Shear wave elastography; Superb micro-vascular imaging