The application value of ultrasound elastography in the diagnosis of breast nodules

To investigate the difference of efficacy between UE and CDUS in the differential diagnosis of benign and malignant breast nodules, and to analyze the clinical incremental diagnostic value of UE in cases missed by CDUS. The imaging data of 65 patients with breast nodules confirmed by pathology from January 2020 to December 2021 were retrospectively analyzed. All lesions were evaluated by CDUS blood flow grading and UE stiffness score before operation. With postoperative histopathological results as the gold standard, the sensitivity, specificity, accuracy and Kappa consistency of the two methods were compared, and the differences in diagnostic efficacy were analyzed. Among the 65 nodules, 48 were pathologically malignant and 17 were benign. The sensitivity, specificity and accuracy of CDUS were 72.9%, 70.6% and 72.3%, respectively. The sensitivity, specificity and accuracy of UE were 95.8%, 94.1% and 95.4%, respectively. The diagnostic efficacy of UE was significantly better than that of CDUS. Among the 13 hypovascular malignant nodules missed by CDUS, UE correctly identified 11 nodules based on hardness features (salvage rate 84.6%), and only 2 cases of mucinous carcinoma showed false negative results. The agreement between UE and pathological results was extremely high, which was significantly better than the moderate agreement of CDUS. Compared with CDUS based on hemodynamics, UE based on tissue biomechanical properties has higher sensitivity and specificity in differentiating benign and malignant breast nodules. UE can effectively correct the misjudgment of CDUS caused by delayed tumor angiogenesis or benign hypervascularity, which has important clinical incremental diagnostic value. It is recommended to be used in combination with conventional ultrasound.