Role of dynamic quantitative evaluation in liver transplantation by ultrasonic elastography / 中华超声影像学杂志

Objective:To investigate the role of combinational elastography in the dynamic quantitative evaluation of liver transplantation.Methods:From April to December 2019 in Tianjin First Central Hospital, 27 cases of the liver transplant patients and donors were examined by shear wave elastography and real-time tissue elastography, respectively on donor preoperative within 24 h and postoperative day 1, day 7, in order to obtain liver elastic modulus E, measured average relative strain value (MEAN), the index activity (A) and acoustic attenuation measurement (ATT), and to obtain pathologic specimens during operation, including: hydropic degeneration, inflammation, necrosis, steatosis. AST, ALT, TB, DB were detected by automatic biochemistry analyzeron postoperative day 1, day 7. Correlation analysis was performed for pathological parameters and ultrasonic parameters, E, MEAN, A, ATT were selected to plot ROC curve, to analyze ultrasonic parameters′ cut-off value and area under the curve(AUC). According to the pathological signs donor liver were divided into no or mildhydropic group and moderate-to-severehydropic group, non-inflammation group and inflammation group, non-steatosis group and steatosis group. Ultrasonic parameters of donor liver were compared between the two groups, and differences in liver function and ultrasonic parameters on postoperative day 7 were analyzed between the two groups. The change trends of ultrasonic parameters were analyzed from preoperative donor liver to postoperative day 1, day 7 of recipient. The changes of liver function were analyzed from the first day to 7th days. Correlation analysis was performed for liver function and ultrasonic parameters respectively on postoperative day 1, day 7.Results:①Correlation of the ultrasonic parameters of donor liver preoperative within 24 h and pathological parameters: E value and hydropic degeneration and inflammation of pathological signs were significantly and positively correlated( rs=0.597, 0.497; all P<0.05); MEAN and hydropic degeneration and inflammation of pathological signs were significantly and negatively correlated( rs=-0.601, -0.584; all P<0.05); A and inflammation of pathological signs was significantly and positively correlated( rs=0.452, P=0.016); ATT and steatosis of pathological signs was significantly and positively correlated ( rs=0.564, P=0.006). ②The differences of ultrasonic parameters of donor liver preoperative within 24h: E value of moderate-to-severehydropic group was significantly higher than that of the no or mild hydropicgroup ( P<0.001), MEAN value of moderate-to-severehydropic group was significantly lower than that of the no or mildhydropicgroup( P<0.001). E value of inflammation group was higher than that of non-inflammation group ( P=0.012), MEAN value of inflammation group was lower than that of non-inflammation group ( P=0.026). ATT of steatosis group was higher than that of non-steatosis group ( P=0.006). ③The ROC curve indicated that AUCs of E and MEAN diagnosing hydropic degeneration were 0.882, 0.875, and the critical value were respectively 8.72 kPa, 106.62; the AUC of diagnosing inflammation was 0.898, the critical values was 1.26; the AUC of diagnosing steatosis liver was 0.868, the critical value was 0.515 dB·cm -1·MHz -1. ④There were no statistically significant differences in liver function and ultrasonic parameters on postoperative day 7 between no or mildhydropic group and moderate-to-severehydropic group(all P>0.05). There were no statistically significant differences in liver function and ultrasonic parameters on postoperative day 7 between non-inflammation group and inflammation group(all P>0.05). There were no statistically significant differences in liver function and ultrasonic parameters on postoperative day 7 between non-steatosis and steatosis group (all P>0.05). ⑤E and A values of postoperative day 1 were higher than those of preoperative donor liver and postoperative day 7(all P<0.05), MEAN value of postoperative day 1 was lower than those of preoperative donor liver and postoperative day 7(all P<0.05). ATT of postoperative day 1 was lower than that of preoperative donor liver( P=0.027). ⑥ALT, AST, TB, DB of postoperative day 7 were lower than that of postoperative day 1, the difference was statistically significant ( P<0.05). ⑦On postoperative day 1: E value and ALT, AST, TB, DB were significantly and positively correlated( r=0.641, 0.673, 0.601, 0.575; all P<0.05); MEAN value and ALT, AST were significantly and negatively correlated( r=-0.690, -0.703; all P<0.001); A value and ALT, AST were significantly and positively correlated( r=0.459, 0.442; all P<0.05). On postoperative day 7: E value and ALT, AST, TB, DB were significantly and positively correlated ( r=0.616, 0.729, 0.505, 0.640; all P<0.05); MEAN value and ALT, AST were significantly and negatively correlated( r=-0.602, -0.585; all P<0.05); A value and ALT, AST were significantly and positively correlated( r=0.411, 0.495; all P<0.05). Conclusions:Combinational elastography can dynamically and quantitatively assess the hardness, inflammation, steatosis of liver transplantation, and ultrasonic parameters correlate significantly with pathological and liver function, and provides a certain imaging basis for clinical evaluation of liver quality.

Effect of 's subcutaneous needling on thickness and elasticity of affected muscles in shoulder neck pain based on ultrasonic elastography / 中国针灸

OBJECTIVE@#To observe the effect of 's subcutaneous needling on thickness and elasticity of affected muscles in subjects with shoulder neck pain by ultrasonic elastography.@*METHODS@#A total of 30 subjects with upper trapezius pain and local tenderness, or stiffness and funicular nodules were observed randomly, right shoulders were as observation group and left shoulders were as control group. Simple resistance training was adopted in the control group. At the same time of the resistance training, sweeping technique of 's subcutaneous needling was adopted at the local tenderness or the stiffness and funicular nodules of upper trapezius in the observation group. The treatment was given once in both groups. Before and immediately after treatment, thickness and elasticity of bilateral upper trapezius and supraspinatus were observed by ultrasonic elastography, and the variations of visual analogue scale (VAS) score were observed in the two groups.@*RESULTS@#Compared before treatment, the elasticity of upper trapezius and supraspinatus were decreased after treatment in both groups (<0.05), and those in the observation group were lower than the control group (<0.05). Compared before treatment, the VAS scores after treatment were decreased in both groups (<0.05), and that in the observation group was lower than the control group (<0.05).@*CONCLUSION@#'s subcutaneous needling can increase the elasticity and release the muscular tension of affected muscles, and relieve pain in subjects with shoulder neck pain.

Algorithm for Estimating Tissue Strain Based on Optical Flow / 中国医疗器械杂志

Because the translation hypothesis of optical flow method can not accurately describe the form of motion after tissue compression, so we proposed a new ultrasonic elastic imaging algorithm. It was assumed that the deformation of the tissue was affine transformation when the probe was pressed to the tissue, and the displacement and strain distribution were estimated simultaneously by the optical flow method combined with the prior estimation. In order to verify the effectiveness of the algorithm, the imaging quality of the algorithm and the other imaging algorithm were compared with the simulated radio frequency echo signal. The results show that the new algorithm is higher in signal to noise ratio (SNRe), contrast to noise ratio (CNRe) and running speed than the contrast algorithm under 8% compression. The results show that the new proposed algorithm can effectively estimate axial displacement and axial strain in the case of large compression.

Carotid Plaque Stiffness Measured with Supersonic Shear Imaging and Its Correlation with Serum Homocysteine Level in Ischemic Stroke Patients

OBJECTIVE: To ascertain the feasibility of using shear wave velocity (SWV) in assessing the stiffness of carotid plaque by supersonic shear imaging (SSI) and explore preliminary clinical value for such evaluation. MATERIALS AND METHODS: Supersonic shear imaging was performed in 142 patients with ischemic stroke, including 76 males and 66 females with mean age of 66 years (range, 45–80 years). The maximum, minimum, and mean values of SWV were measured for 129 carotid plaques. SWVs were compared between echolucent and echogenic plaques. Correlations between SWVs and serum homocysteine levels were investigated. Based on neurological symptom, the surrogate marker of vulnerable plaque (VP), binary logistic regression was performed and area under curve (AUC) of homocysteine only and homocysteine combing SWVmean was calculated respectively. RESULTS: Echogenic plaques (n = 51) had higher SWVs than echolucent ones (n = 78) (SWVmin 3.91 [3.24–4.17] m/s vs. 1.51 [1.04–1.94] m/s; SWVmean, 4.29 [3.98–4.57] m/s vs. 2.09 [1.69–2.41] m/s; SWVmax, 4.67 [4.33–4.86] m/s vs. 2.62 [2.32–3.31] m/s all p values < 0.01). Pearson correlation analysis showed that stiffness of plaques was negatively correlated with homocysteine level. R values for SWVmin, SWVmean, and SWVmax were −0.205, −0.213, and −0.199, respectively. Binary logistic regression analysis showed that sex (p = 0.008), low-density lipoprotein (p = 0.015), triglycerides (p = 0.011), SWVmean (p = 0.004), and hyper-homocysteinemia (p = 0.010) were significantly associated with symptomatic ischemic stroke. Receiver operating characteristic curves revealed that SWVmean combing serum homocysteine level (AUC = 0.67) presented better diagnostic value than serum homocysteine only (AUC = 0.60) for symptomatic ischemic stroke. CONCLUSION: Supersonic shear imaging could be used to quantitatively evaluate stiffness of both echolucent and echogenic carotid plaques. More importantly, SWVs of plaques were not only correlated to serum homocysteine level, but also associated with symptomatic ischemic stroke, suggesting that SSI might be useful for understanding more about VP.

Application of Real-time Ultrasound Elastography for Preoperative Staging of Rectal Cancer / 中国医科大学学报

Objective To explore the role of real-time ultrasound elastography (RUE) in the staging of rectal cancer.Methods We retrospectively analyzed 41 cases of rectal cancer by both double plane transrectal conventional ultrasonography (CU) and RUE and comparatively assessed elasticity scores and strain ratios (SR) of the tumor along with postoperative pathological staging results.Results The accuracy of CU for preoperative staging of rectal tumors was 80.49％.There were significant differences between the elasticity scores and strain ratios of the T1 stage and T2,T3,and T4 stages,and also in elasticity scores and strain ratios of the T4 stage and T2 and T3 stages of rectal cancer by using RUE (P ＜ 0.05).Taking the elasticity score of 3 points as the optimal ritical value in the diagnosis of the T1 stage of rectal cancer,the sensitivity,specificity,positive predictive value,and negative predictive value were 66.67％,96.88％,85.71％,and 91.18％ respectively.Condusion Endorectal RUE can assess the elastic stiffness of rectal cancer,and it helps in the preoperative staging of rectal cancer.

The value of combined scoring of contrast-enhanced ultrasound and ultrasonic elastography in the differential diagnosis of TI-RADS 4 nodules / 中华超声影像学杂志

Objective To evaluate the diagnostic value of combined scoring of contrast enhanced ultrasound(CEUS) and ultrasonic elastography(UE) for thyroid imaging reporting and date system(TI RADS) 4 type nodules.Methods The CEUS and UE features of 520 TI RADS 4 type nodules were analyzed retrospectively.The scores of each nodule were evaluated and compared with pathological results and fine-needle aspiration cytology(FNAC).ROC curve was used to compare the diagnostic value of CEUS combined with UE or alone in the differential diagnosis of TI-RADS 4 nodules.Results The sensitivity,specificity,accuracy and area under the curve(AUC) of UE were 82.34％,82.25％,82.31％ and 0.841,respectively,when the cut off value of UE score was 4.The sensitivity,specificity,accuracy and AUC of CEUS were 78.63％,65.68％,74.42％ and 0.750,respectively,when the cut-off value of CEUS score was 4.The sensitivity,specificity,accuracy and AUC of CEUS combined with UE were 92.31 ％,75.74％,86.92％ and 0.885,respectively,when the cut-off value of combined score was 6.The sensitivity and accuracy of combined score were higher than those of two other methods,the difference was statistically significant (all P ＜ 0.05),the AUC of combined score was the biggest,it had the highest diagnostic efficacy.Conclusions Combined scoring of CEUS and UE can improve the accuracy in the differential diagnosis of TI-RADS 4 type nodules.

Effect of Ultrasound Elastic Imaging and Contrast-enhanced ultrasound in the Evaluation of Hepatic Fibro-sis in Patients with Chronic Hepatitis B / 实用医学杂志

Objective To evaluate the effect of ultrasound elastography and radiography in the assessment of hepatic fibrosis in chronic hepatitis B patients. Methods Seventy patients with chronic hepatitis B were en-rolled in our hospital from August 2014 to August 2016. Liver ultrasonography was performed in all patients. HAVTT1 and HAVTT2 were measured by visual method. SWV was measured by ultrasonic elasticity imaging. Re-sults With the increase of liver fibrosis,SWV test also increased,while HAVTT gradually shortened.The correct rates of HAVTT1 and HAVTT2 and SWV in the diagnosis of liver fibrosis were 72.36%,76.84% and 89.78%.The diagnostic accuracy of SWV was higher than that of HAVTT1 and HAVTT2,the difference was statistically sig-nificant(P<0.05).Conclusion Acoustic contrast measurement of HAVTT1 and HAVTT2 can reflect the chang-es of liver microcirculation,which is helpful to distinguish liver cirrhosis,fibrosis and no fibrosis. The measure-ment of SWV can reflect the difference of texture hardness of liver,which can be used as a kind of judgment on the degree and effect of hepatic fibrosis new method.

A research on the assessment of color Doppler ultrasound combined with ultrasonic elastography for curative effect of neoadjuvant chemotherapy for breast cancer / 中国医学装备

Objective:To evaluate the value of color Doppler ultrasound combined with ultrasonic elastography for curative effect of neoadjuvant chemotherapy (NAC) for breast cancer.Methods: 100 patients with breast cancer who has received NAC were divided intoobservation group (50 cases, underwent examination of color Doppler ultrasound scanner combined with ultrasonic elastography) and control group (50 cases, only underwent examination of color Doppler ultrasound scanner) according to the different examination methods. The accuracy, sensitivity and specificity of differential diagnosis methods for curative effect of NAC between the two groups were compared as above data.Results: The accuracy, sensitivity and specificity of differential diagnosis for curative effect of NAC in observation group were 88.00％, 90.00％ and 86.00％, respectively. While them of control group were 78.00％, 80.00％ and 76.00％, respectively. And the differences of these indicators between the two groups were statistically significant (x2=2.01,x2=3.24,x2=3.45, P<0.05).Conclusions: Color Doppler ultrasound combined with ultrasound elastography can diagnose the curative effect of NAC for patients with breast cancer from two aspects which includes tissue hardness and blood supply, and it can achieve more diagnostic accuracy compared with only using simple color Doppler ultrasound.

Application of Ultrasonic Elastography in Diagnosis of Chronic Nonspecific Low Back Pain / 中国康复理论与实践

Objective To evaluate the value of ultrasonic elastography for diagnosis of chronic nonspecific low back pain. Methods From March to September, 2016, 32 patients diagnosed as chronic nonspecific low back pain and other 32 healthy people (controls) were measured lumbar erector spinae with ultrasonic elastography, and calculated Yang's modulus. The correlation between Yang's modulus and Visual Analogue Scale (VAS) or Japanese Orthopaedic Association (JOA) score in the patients were investigated with Pearson's analysis. Re-sults There was no significant difference in Yang's modulus between bilateral lumbar erector spinae in both the patients and the controls (t0.05), but it was more in the patients than in the controls (t=9.931, P<0.001). The Yang's modulus was positively correlated with VAS score in the patients (r=0.614, P<0.001), but not with the JOA score (r=-0.243, P=0.180). Conclusion Ultrasonic elastography can be applied to differentiate low back pain from the healthy, and measure the intensity of pain.

The value of contrast-enhanced ultrasound combined with ultrasound elastography scores in differential diagnosis of breast imaging reporting and data system 3-4 breast lesions / 中华医学超声杂志（电子版）

Objective To explore the value of contrast-enhanced ultrasound (CEUS) scores, ultrasonic elastography (UE) and their combined scores in diagnosing breast lesions of breast imaging reporting and data system (BI-RADS) 3-4. Methods From October 2015 to March 2016, 60 BI-RADS 3-4 solid breast masses diagnosed by conventional ultrasound underwent UE and CEUS. According to the relevant indicators, all cases were scored and proved by surgical pathology. The diagnostic sensitivity, specificity and accuracy of CEUS scores, UE and their combined scores were evaluated, and the receiver operating characteristic (ROC) curve was drawn. Results Twenty-nine benign and 31 malignant lesions were confirmed by pathology. The area under the ROC curve of CEUS combined with UE scores was 0.971 which was higher than that of CEUS Scores and UE alone (0.916 and 0.908, respectively). Moreover, the sensitivity, specificity and accuracy were 87.1%, 96.6% and 92.0% for CEUS combined with UE Scores, 77.4%, 93.1% and 85.0% for CEUS Scores, 74.2%, 93.1% and 83.3% for UE, respectively. Conclusion CEUS combined with UE scores can improve the differetial diagnostic accuracy for BI-RADS 3-4 breast lesions.

Investigation of correlation between real-time ultrasound elastosonography score and autoimmunity in patients with hashimoto thyroiditis / 中国免疫学杂志

Objective:To investigate the correlation between ultrasonic elasticity score ,elasticity coefficient and autoimmune thyroid function in patients with HT ( hashimoto thyroiditis ) .Methods: Used GE LOGIQ3 type Color Doppler Ultrasound Diagnostic System to acquire satisfactory elastosonography from 216 patients with HT,and evaluated the elasticity score and elasticity coefficient;to detecte the thyroid function and the titer of Thyroid peroxidase antibody ( TPOAb ) , Thyroid globulin antibody ( TgAb ) by chemiluminescence ,respectively investigated the correlation between ultrasonic elasticity score , elasticity coefficient and autoimmune thyroid function.Results:Serum Thyroid stimulating hormone (TSH),TGA and TPO in 216 patients with HT increased significantly , TgAb and elastic coefficient were positively correlated , r=0.54 , P<0.01;TgAb and elasticity score were positively correlated , r=0.496 ,P<0.01;TPOAb and elastic coefficient were positively correlated ,r=0.77 ,P<0.01 ,TPOAb and elasticity score were positively correlated,r=0.73,P<0.01.Conclusion: Real-time ultrasound elastography in combination with measurement of autoimmune thyroid function was helpful to diagnosis of HT .

Diagnostic advances of thyroid cancer in ultrasonography / 中国癌症杂志

Thyroid cancer is the most prevalent cancer of endocrine tumors. Its correct diagnosis and differential diagnosis play very important roles in its treatment and prognosis. Ultrasonography, as its powerful tool, is clinically widely used. This article made a review about its main diagnostic methods, including conventional ultrasound, contrast-enhanced ultrasonography and ultrasonic elastography, in order to relfect their panorama.

The diagnostic value of ultrasound elastography in breast tumor and analyze the significance of joint DWI / 重庆医学

Objective To evaluate the value of ultrasound elastography in the diagnosis of breast tumor ,and compared with imaging analysis .Methods To collect the image data of 160 patients ,confirmed by pathology ,a total of 182 ,preoperative ultra-sound elasticity imaging and DWI ,ultra sonic elastography diagnosis by five points method ,DWI on the basis of the measured ADC value in the diagnosis of lesions ,respectively compared with pathology .Results Ultrasound elastography diagnosis of 89 malignant tumors ,of which the correct diagnosis of 78 malignant tumors ,7 misdiagnosis ,11 benign misdiagnosed as malignant diagnosis;93 benign tumors ,86 of correct diagnosis ,11 misdiagnosis ,7 malignant misdiagnosed as benign ,sensitivity was 87 .6% ,specificity of 92 .5% ,the Accuracy was 93 .9% ;ultrasound elastography and DWI combined imaging diagnosis of 86 malignant tumors ,81 correct diagnosis of malignant tumors ,4 misdiagnosis ,5 from the benign misdiagnosed as malignant diagnosis ,96 benign tumors ,92 correct diagnosis ,5 misdiagnosis ,the sensitivity was 94 .1% ,specificity of 95 .8% ,the accuracy was 97 .2% .Conclusion Ultrasound elas-tography in breast benign and malignant tumor diagnosis with higher sensitivity and specificity ,accuracy ,joint DWI can significantly improve the sensitivity and specificity of breast benign and malignant tumor diagnosis ,accuracy .

Diagnostic value of ultrasonic elastography in benign and malignant thyroid nodules：a Meta-analysis / 中华地方病学杂志

Objective To evaluate the diagnostic value of ultrasonic elastography (UE) in benign and malignant thyroid nodules by Meta analysis. Methods Computer was used to search China national knowledge infrastructure(CNKI), Wanfang database, and relevant Chinese articles about UE in assessing diagnostic accuracy of benign and malignant thyroid nodules were collected. According to the diagnostic test criteria recommended by Cochrane Screening and Diagnostic Test Group, the literatures were screened and feature information was included in the study. The quality evaluation tool of diagnostic test accuracy(QUADAS-2) was used to assess the quality of the literatures; Meta analysis was performed with Meta-DiSc 1.4 software, and receiver operating characteristic curve(SROC) was drawn. Results According to the key words, two hundred and thirty-one articles were retrieved initially, and finally 16 articles were included after screening; the quality of five articles was grade A; eight was grade B; and three was grade C. Sixteen articles contained 1 325 patients with 1 641 thyroid nodules. The pooled sensitivity and specificity were 0.87 [95%confidence interval (CI): 0.84 - 0.89] and 0.84 (95%CI: 0.82 - 0.86), respectively; the pooled positive and negative likelihood ratios were 5.85 (95%CI:4.47-7.65) and 0.17(95%CI:0.13 - 0.21), respectively; the area under the curve of SROC was 0.93, standard error(SE) =0.01. Conclusion The results of meta-analysis suggest that UE has high value in the diagnosis of benign and malignant thyroid nodules.

Diagnostic value of conventional ultrasonography combined with ultrasonic elastography for breast intra-ductal papillary lesion / 医学研究生学报

Objective Breast intraductal papillary lesion ( BIPL) has a low incidence but a high rate of malignancy .This study discusses the diagnostic value of conventional ultrasonography ( US) combined with ultrasonic elastography ( UE) for breast papil-lary lesion. Methods We analyzed the preoperative ultrasound data of 48 patients with 63 BIPLs, and classified them according to the characteristics of two-dimensional ultrasound (2DUS) images.Then we compared their color Doppler ultrasound characteristics and UE features with the pathological results . Results Based on the 2DUS findings, the BIPLs were divided into 4 types.The sensitivi-ty, specificity, and accuracy of conventional US +UE in the diagnosis of BIPL were 93.2%, 88.9%, and 90.5%, respectively, markedly higher than those of conventional US (75.6%, 66.7%, and 73.0%), with statistically significant differences in the areas under the curve between the two methods (0.918 vs 0.838, P<0.05). Conclusion Conventional US combined with UE can im-prove the diagnosis of breast intraductal papillary lesion .

A comparative study of diagnostic value between ultrasonic elastography and ultrasound contrast imaging on thyroid microcarcinoma / 中国中西医结合急救杂志

Objective To evaluate the value of the application of ultrasonic elastography and ultrasound contrast imaging on thyroid microcarcinoma(TMC). Methods The in-patients with thyroid lesions admitted in the Second People's Hospital of Foshan City from January 2013 to April 2014 were enrolled. Two-dimensional ultrasonography was used to screen the 162 solid thyroid nodules with a diameter ≤10 mm;they were examined by ultrasonic elastography and ultrasound contrast imaging respectively,and the result of pathological examination was regarded as the golden standard to compare the sensitivity and specificity between ultrasonic elastography and ultrasound contrast imaging for the diagnosis of TMC. Results The pathological results showed there were benign nodules 118 and malignant nodules 44 in number. The sensitivity,specificity,incidence of accuracy,positive predictive value and negative predictive value of the diagnosis of TMC by ultrasonic elasticity imaging,ultrasound imaging,and elasticity imaging combined with ultrasound imaging were much higher than those by two-dimensional ultrasonography〔sensitivity:88.64%(39/44),90.91%(40/44),95.45%(42/44)vs. 81.82%(36/44);specificity:91.53%(108/118),92.37%(109/118),95.76%(113/118)vs. 85.59%(101/118);accuracy:90.74%(147/162), 91.97%(149/162),93.26%(151/162)vs. 84.56(137/162);positive predictive value:79.59%(39/49),81.63%(40/49),83.67%(41/49)vs. 67.92%(36/53);negative predictive value:95.58%(108/113),96.46%(109/113), 97.35%(110/113)vs. 92.66%(101/109),all P<0.05〕. Conclusion For the diagnosis of TMC,both ultrasonic elastography and ultrasound contrast imaging have rather high value,and when they are combined together to be applied for the diagnosis,the result is the best.

Correlation between elastography score and strain rate ratio in breast small tumor / 中南大学学报(医学版)

Objective To explore the value of elastography score and strain rate ratio in the diagnosis of small breast malignant focus. Methods We retrospectively analyzed 22 patients with breast small malignant foci less than 10 mm. Ultrasound characteristics were summed up in breast small cancer. Results On elastogram, 2 patients scored 3, 14 scored 4 and 6 scored 5.The average strain rate ratio of all foci was 4.76, and there was correlation between it and elastography scores. Conclusion Ultrasonic elastography has important value in the diagnosis of breast small cancer.