title: Influence of various breast factors on the quality of strain elastograms.
abstract: OBJECTIVE
  To determine the influence of the depth and size of breast lesions, the thickness of the adipose layer, and the thickness of the breast on the quality of strain elastograms obtained from Chinese women.
  
  
  METHODS
  Ultrasound elastography was conducted on 326 breast lesions in 272 women. The quality of the images was evaluated according to criteria for satisfactory and unsatisfactory elastograms. Univariate and multivariate logistic regression analyses were conducted to determine the relationship between measured factors and image quality.
  
  
  RESULTS
  Among the 326 lesions, 300 (92%) had satisfactory images, and 26 (8%) had unsatisfactory images. Univariate analyses indicated that all of the data from the unsatisfactory group were higher than the data from the satisfactory group in terms of the distance from the deep and superficial edges of the lesion to the skin, the thickness of the adipose layer anterior to the lesion, and the breast thickness at the location of the lesion (all P < .05 ). Lesions in the unsatisfactory group were larger than those in the satisfactory group when the distance from the deep edge of the lesion to the skin was between 2.1 and 2.5 cm and the distance from the superficial edge of the lesion to the skin was between 1.6 and 2.3 cm (all P< .05). Multivariate logistic regression analysis revealed that both the distance from the superficial edge of the lesion to the skin (odds ratio, 18.335; P = .029) and the breast thickness at the location of the lesion (odds ratio, 20.447; P < .001) were the independent influencing factors that affected the quality of elastograms.
  
  
  CONCLUSIONS
  Satisfactory images are more easily acquired if the lesion is relatively superficial or located in areas of thinner breast thickness. Furthermore, among deeper lesions, satisfactory images are more common in large lesions.
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Guo
authors.initials: G
authors.lastname: Song
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China. 714960945@qq.com.
authors.forename: Li
authors.initials: L
authors.lastname: Jing
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Ma
authors.initials: M
authors.lastname: Yan
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Shang
authors.initials: S
authors.lastname: Cong
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Xuejiao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult
keywords: breast; breast ultrasound; elastography; imaging; influencing factors; sonography