Superb microvascular imaging in combination with ultrasonic elastography and high-frequency ultrasound in micro breast cancer:an assessment on the diagnostic efficacy and screening for high-risk features on ultrasound

Abstract

Abstract:

Objective:To analyze the diagnostic value of superb microvascular imaging (SMI) in combination with ultrasonic elastography (UE) and high-frequency ultrasonography on micro breast cancer and screening for high-risk features on ultrasound.Methods:A total of 87 breast lesions from 85 patients were collected. The maximum diameters of the lesions were no more than 1 cm,and all lesions were classified as BI-RADS （Breast Imaging Reporting and Data System） 4. The lesions were grouped into benign and malignant groups based on results of postoperative pathology. The characteristics of grey-scale ultrasound and color Doppler flow imaging(CDFI), SMI and elasticity scores of the lesions were compared between 2 groups and high-risk features on ultrasound for micro breast cancer were screened.Results:Univariate analysis showed that lesion morphology, margin, calcification status, elasticity score, SMI and CDFI classification were statistically different between benign and malignant groups (P<0.05). Multivariate Logistic regression analysis revealed that lesions with ill-defined margin, elasticity score ≥4 or Adler scale of SMI ≥Ⅱ were independently predicting factors for micro breast cancer. The accuracy of combining the three indices for diagnosing micro breast cancer was 81.61%, higher than any single one.Conclusions:High-risk features of micro breast cancer on ultrasound include Adler scale SMI≥Ⅱ and elasticity score ≥4. Both features in combination with ill-defined margin show good diagnostic efficiency for micro breast cancer, which may provide an important reference for clinical diagnosis.

Key words:Micro breast cancer,Superb microvascular imaging,Elasticity score,Breast Imaging Reporting and Data System

CLC Number:

R737.7

LU Yejun, CHEN Hui, ZHANG Jian, XU Bin, WANG Chong, HE Ye. Superb microvascular imaging in combination with ultrasonic elastography and high-frequency ultrasound in micro breast cancer:an assessment on the diagnostic efficacy and screening for high-risk features on ultrasound[J]. Journal of Diagnostics Concepts & Practice, 2020, 19(04): 391-396.

Figures/Tables5

超声特征	病理诊断			χ²值	P值
超声特征	良性	恶性	个	χ²值	P值
纵横比				3.048	0.081
<1	33	22	55
≥1	13	19	32
形态				3.982	0.046
规则	18	8	26
不规则	28	33	61
边缘				8.948	0.003
光整	27	11	38
不光整	19	30	49
钙化				3.982	0.046
无	30	18	48
有	16	23	39
弹性评分				26.096	<0.001
<4分	41	15	56
≥4分	5	26	31
Adler（CDFI）				9.557	0.002
<Ⅰ级	25	9	34
≥Ⅰ级	21	32	53
Adler(SMI)				19.724	<0.001
<Ⅰ级	32	9	41
≥Ⅱ级	14	32	46

超声特征参数	灵敏度	特异度	阳性预测值	阴性预测值	准确率
纵横比≥1	46.34	71.74	59.38	60.00	59.77
形态不规则	80.49	39.13	54.10	69.23	58.62
边缘不光整	73.17	58.70	61.22	71.05	65.52
钙化	56.10	65.22	58.97	62.50	60.92
弹性评分≥4分	63.41	89.13	83.87	73.21	77.01
Adler（CDFI）≥Ⅰ级	78.05	54.35	60.38	73.53	65.52
Adler(SMI)≥Ⅱ级	78.05	69.57	69.57	78.05	73.56

超声特征参数	偏回归系数	Waldχ²	OR(95%CI)	P值
边缘不光整	0.955	2.723	2.598(0.836~8.075)	0.099
弹性评分≥4分	2.509	14.537	12.296(3.385~44.662)	<0.001
Adler(SMI)≥Ⅱ级	2.013	11.359	7.489(2.322~24.151)	0.001

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