Comparison of Elastography findings with Color Doppler in Granulomatous Mastitis

Abstract

Idiopathic granulomatous mastitis or IGM is a benign inflammatory breast disease that affects the majority of women of reproductive age with a history of breastfeeding. The clinical manifestations of IGM include a wide range of clinical findings, including pain, inflammation, hyperemia, and the presence of a mass, which is the most common finding among other findings. The use of elastography can also be beneficial in the evaluation of IGM patients. Several reports have also reported the efficacy of elastography in differentiating IGM from Brest malignancies. The current study aims to determine the elastography findings in granulomatous mastitis. Materials and Methods: In this cross-sectional study, 40 patients who were suspected of having granulomatous mastitis after examination by grayscale B mode ultrasound and clinical examination were subjected to a biopsy of the mass and after confirming the diagnosis, they entered the study, and shear wave elastography from the mass was done. Results: The average age of the patients was 36.27±5.50 years, and the most common clinical symptoms were related to a palpable mass (72.5%), pain (55%), and inflammatory findings (40%). 87.5% of lesions were irregular in shape and 12.5% were oval. All lesions had angular or lobulated margins or both. In terms of echogenicity, 82.5% of lesions were Mixed Echo. SW elastography indices for Emax were 51.97±24.12 kPa, Emin was 30.62±17.36 kPa, Emean was 41.13±17.74 kPa, and the ratio of the lesion to normal tissue was 3.38±1.53. Also, there was a direct and significant correlation between color Doppler PSV and EDV indices with each of the SW elastography indices including Emax, Emin, and Emean. Examining the diagnostic value of SW elastography showed that in this modality, based on the ratio index, the cut point for the ratio value was 81.8% sensitivity and 88.9% specificity, equal to 2.1.