To explore the diagnostic value of routine ultrasonography combined with texture analysis in breast nodules based on their gray-scale ultrasound and shear-wave elastography images.

From August 2018 to December 2018, 113 patients with 113 breast nodules were prospectively included, and the breast nodules were found by routine ultrasonography and diagnosed by pathology. All patients underwent conventional ultrasound and shear wave elastography, and 113 breast nodules were classified according to Breast Imaging Reporting and Data System (BI-RADS). Texture feature parameters were obtained through texture analysis of ultrasound images and a diagnostic model was established. Using pathological results as the "golden standard", the diagnostic value of the texture feature diagnostic model and routine ultrasonography combined with the texture feature diagnostic model for benign and malignant breast nodules was analyzed.

Using the pathological results of puncture specimens of breast nodules as the "golden standard", the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of texture analysis in the diagnosis of benign and malignant breast nodules were 0.64, 0.91, 0.75, 0.86, and 0.83, respectively, and the area under the ROC curve (AUC) was 0.77. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of routine ultrasonography combined with texture analysis in the diagnosis of benign and malignant breast nodules were 0.88, 0.85, 0.71, 0.94, and 0.86, respectively, and the AUC was 0.86. The AUC of the combined diagnosis was significantly higher than that of texture analysis (Z=2.133, P=0.03). Based on the combined diagnosis, 90.0% (72/80) of BI-RADS 4a breast nodules could be degraded to BI-RADS 3. Pathological results showed that 94.4% (68/72) of the breast nodules degraded to BI-RADS 3 were benign.

Conventional ultrasound combined with texture analysis has better diagnostic efficacy for benign and malignant breast nodules. The combined diagnosis can reduce needless puncture and has good application prospects.