Objective:

To compare the diagnostic efficacy of 5-point elasticity scoring and strain ratio (SR)

and to explore the value of strain elastography (SE) combined with Breast Imaging Reporting and Data System (BI-RADS) category in differentiating breast lesions.

Methods:

A total of 199 cases of breast lesions were examined with conventional ultrasound and SE

then 5-point elasticity scoring were recorded and SR were calculated. Based on the pathological results as the gold standard

the receiver operating characteristic (ROC) curve were used to compare the diagnostic efficiency. The diagnostic performance was compared between BI-RADS category and SE combined with BI-RADS category.

Results:

The area under curve (AUC) of ROC curve of SR and 5-point method were 0.897 and 0.796 respectively (

P

=0.017). The optimal diagnostic threshold of the SR was 4.03 and the diagnostic accuracy was 87.44%

and the optimal diagnostic threshold of the 5-point method was 3 to 4 point and the diagnostic accuracy was 70.35% (

P

＜0.001). For 3-point lesions

the diagnostic accuracy of the 5-point method was 40.28% significantly less than that of the SR (83.33%

P

＜0.001). For 1-2 point and 4-5 point lesions

there was no significant difference in the diagnostic accuracy between the two methods. The diagnostic sensitivity

specificity

accuracy

positive predictive value and negative predictive value of SE combined with BI-RADS were 99.24%

73.53%

90.45%

87.84% and 98.04%

respectively.

Conclusion:

Five-point method can be used as a preliminary method to evaluate the stiffness information of breast lesions. When the score is 3 points

measurement of SR isneeded to further auxiliary diagnosis. BI-RADS category combined with SE is helpful to the differentiation of benign and malignant breast lesions and to reduce some unnecessary puncture biopsy.