Objective: To explore the diagnostic value of shear wave elastography in ductal carcinoma in situ (DCIS) of the breast, and analyze the causes of misdiagnosis of DCIS and the influencing factors of false negative prediction results of elastic parameters. Methods: From January to October 2019, a total of 148 cases (161 lesions) of patients with breast lesions image data, including 21 ductal carcinoma in situ lesions (DCIS group),19 ductal carcinoma in situ with micro infiltration lesions (DCIS-MI group),21 papillary carcinoma lesions (PC group),50 invasive ductal carcinoma lesions (IDC group) and 50 benign lesions (Benign group) were retrospectively studied. In all cases, the features of the lesions were recorded by ultrasonography, then shear wave elastography was performed and the maximum elasticity (Emax), the minimum elasticity (Emean), the elasticity standard deviation (Esd) and the elasticity ratio (Eratio) were obtained. The differences of sonographic features in five groups, the diagnostic value of elastic parameters in benign and malignant lesions, and the number of false negative cases of malignant lesions in four groups were analyzed. The influencing factors of false negative prediction of elastic parameters in DCIS were discussed. Results: There were statistically significant differences in the size and margin of the lesions among the five groups (all P<0.001).The lesion sizes of the four malignant groups were significantly larger than that of the benign group, and the size of the DCIS group, DCIS-MI group and IDC group showed an increasing trend. There were statistical differences in Emax, Emean, Esd and Eratio among five groups of breast lesions (all P<0.001).The areas under ROC curve of Emax, Emean, Esd and Eratio for the differential diagnosis of benign and malignant breast lesions were 0.869, 0.878, 0.837 and 0.822, respectively. When 77.48 kPa, 29.68 kPa, 9.95 kPa and 2.78 kPa were selected, the diagnostic efficiency was the best. The false negative rate of the DCIS group was the highest. In the DCIS group, the false negative prediction results of Emax and Esd were related to lesion size (P=0.022, 0.004), and the false negative prediction results of Esd were related to lesion orientation(P=0.012). Conclusion: The elastic parameters of DCIS group are between the benign group and three groups of malignant lesions (DCIS-MI group, PC group and IDC group), which maybe the reason of shear wave elastography misdiagnosis. Maybe it has a certain correlation between false negative prediction results of Emax or Esd and the size or orientation of DCIS lesions.
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