Clinical value of strain elastography in assessing perilesional tissue stiffness of breast masses for differentiating benign and malignant breast lesions
DONG Kang
CUI Xuhan
LIU Yin
FAN Chenchen
ZHANG Xiaojing
WANG Bing
Abstract：Objective To explore the clinical value of the strain ratio(SR)technique in strain elastography(SE)for evaluating the stiffness of perilesional tissue around breast masses.Methods A total of 195 female patients with 195 breast masses who underwent surgical treatment at the First Affiliated Hospital of Bengbu Medical University from September 2023 to July 2025 were prospectively enrolled.All patients underwent both conventional ultrasound and SE examinations.The strain ratio method was used to semi-quantitatively assess the stiffness of breast masses and their perilesional tissues at 1 mm,2 mm,and 3 mm distances.Pearson correlation analysis was performed to examine the correlation between the strain ratios of the masses and their corresponding perilesional tissues.ROC curves were constructed to compare the diagnostic performance of conventional ultrasound,individual SE parameters,and the combination of conventional ultrasound with the optimal SE parameter.Results Among the 195 masses,91 were malignant and 104 were benign.The strain ratios of malignant masses and their 1 mm,2 mm,and 3 mm perilesional tissues were significantly higher than those of the benign group(P<0.001).Correlation analysis revealed that in the malignant group,the strain ratio between the mass and its 1 mm perilesional tissue exhibited the strongest correlation(r=0.91,P<0.001).ROC curve analysis demonstrated that the SE parameter(B/shell 1)achieved the best diagnostic performance,with a sensitivity of 89%,specificity of 82.7%,accuracy of 85.6%,and an area under the curve(AUC)of 0.921.The combination of BI-RADS classification and B/shell 1 further improved diagnostic efficacy,yielding an AUC of 0.944.Conclusion The perilesional tissue surrounding malignant breast masses exhibits higher stiffness than that around benign masses,and the strain ratio between the mass and its 1 mm perilesional tissue shows a significant correlation.The strain ratio of the 1 mm perilesional tissue(B/shell 1)is the optimal SE parameter for differentiating benign and malignant breast masses,and its combination with BI-RADS classification can further enhance diagnostic performance.
Keywords：elastographystrain ratiobreast cancerperilesional tissue
Publication Date：2026-02-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：7( 190-196 )