Abstract:

Objective

To analyze the viscosity characteristics of breast masses and investigate the clinical value of ultrasound viscoelasticity imaging in the differential diagnosis of benign and malignant breast masses.

Methods

A total of 151 patients with breast masses (≤3 cm ) were prospectively collected in the First Affiliated Hospital of Nanchang University from September 2023 to June 2024.Conventional ultrasound, ultrasound viscoelasticity imaging, and shear wave elastography were performed before puncture biopsy or surgery.The elastic parameters and viscoelastic parameter values of the mass area and the 2 mm glandular tissue around the mass were measured.Taking the pathological results as the gold standard, the elastic and viscoelastic parameters with the largest area under the receiver operating characteristic curve(AUC) were selected as the optimal parameters.The breast imaging reporting and data system (BI-RADS)classification was adjusted according to the optimal cutoff values, and the adjusted diagnostic efficacy and accuracy were compared.

Results

This study included 151 lesions, of which 87 were diagnosed as benign lesions and 64 as malignant lesions.The best elasticity-related parameter for distinguishing benign and malignant breast masses was the maximum elasticity value of 2 mm glandular tissue around the mass(S-E_max), the best viscosity coefficient-related parameter was the maximum viscosity coefficient value of 2 mm glandular tissue around the mass (S-V_max), and the best dispersion coefficient-related parameter was the maximum dispersion coefficient value of 2 mm glandular tissue around the mass (S-D_max).The best cutoffvalues of these parameters were 89.76 kPa, 6.31 Pa·s, and 15.37 m/s/kHz, respectively.After adjusting the BI-RADS classification by the optimal cutoff values of S-E_max, S-V_max, and S-D_max, the accuracy rates were 88.08%, 90.73%, and 84.77%, and the AUC were 0.902, 0.920, and 0.899, respectively, which were all higher than the accuracy (80.13%) and AUC (0.847) before adjustment (P＜0.05).Among them, the AUC of BIRADS classification adjusted by S-V_max was the highest, but there was no significant difference compared with those of the other two (P＞0.05).

Conclusions

Ultrasound viscoelasticity imaging technology can reflect the viscosity information of breast masses and their surrounding tissues.It has diagnostic efficacy comparable to that of shear wave elastography in differentiating benign from malignant breast masses and has potential clinical application value.

Key words: Breast mass, Ultrasonography, Viscoelasticity, Elasticity, Differential diagnosis