Evaluation of internal and shell stiffness in the differential diagnosis of breast non-mass lesions by shear wave elastography

Figure 1 Mass-velocity dynamic dual pattern. Homogeneous green background is shown on the left image. The “stiff rim” sign (a ring of red and orange round the lesions) is shown on the right image. RLB index: Reliable index.

Figure 2 Gray-scale-velocity dual pattern. The traced line of the outer edge (white circle) of the NMLs and the shell at 2.5 mm (pink circle) can be seen on the left image. A “stiff rim” of red and orange can also be seen on the right image. Mean, maximum, and minimum elastic values and the standard deviation were 33.80 kPa, 92.869 kPa, 6.23 kPa and 14.41 kPa, respectively, for internal elasticity, and 81.15 kPa, 167.97 kPa, 5.03 kPa and 28.05 kPa, respectively, for the shell at 2.5 mm. The pathology result was infiltrating ductal carcinoma. A: The area within the lesion. Shell: The area around the lesion. Emax: Maximum; Emean: Mean; Min: Minimum; Esd: Elastic values and the standard deviation.

Figure 3 Gray-scale-velocity dual pattern. This shows the traced line of the outer edge (white circle) of the NMLs and the shell at 2.5 mm (pink circle) on the left image, and no “stiff rim” on the right image. Mean, maximum, minimum elastic values and the standard deviation were 17.03 kPa, 40.89 kPa, 3.23 kPa and 6.93 kPa, respectively, for internal elasticity, and 12.74 kPa, 37.00 kPa, 2.51 kPa and 7.90 kPa, respectively, for the shell at 2.5 mm. The pathology result was adenosis. A: The area within the lesion; Shell: The area around the lesion. Emax: Maximum; Emean: Mean; Min: Minimum; Esd: Elastic values and the standard deviation.

Figure 4 Receiver operating characteristic curves for internal and peripheral elasticity parameters of the shell at 1 mm, 1. 5 mm, 2 mm, 2.5 mm, and 3 mm, respectively. A: Receiver operating characteristic curves for internal elasticity parameters maximum (Emax), mean (Emean), minimum (Emin) elastic values and the standard deviation (Esd), the area under the curve (AUC) was 0.707, 0.626, 0.425 and 0.687, respectively; B: Emax and Emean of the shell at 1 mm (as E1max and E1mean), AUC was 0.795 and 0.647 respectively; C: Emax and Emean of the shell at 1.5 mm (as E1.5max and E1.5mean), AUC was 0.789 and 0.692, respectively; D: Emax and Emean of the shell at 2 mm (as E2max and E2mean), AUC was 0.826 and 0.704, respectively. E: Emax and Emean of the shell at 2.5 mm (as E2.5max and E2.5mean), AUC was 0.900 and 0.746, respectively; F: Emax and Emean of the shell at 3 mm (as E3max and E3mean), AUC was 0.881 and 0.734, respectively. Emax: Maximum; Emean: Mean; Min: Minimum; Esd: Elastic values and the standard deviation; AUC: The area under the curve.