發(fā)布時(shí)間：2018-02-02 03:33

  本文關(guān)鍵詞： 超聲檢查 鉬靶 乳腺腫物 自動(dòng)乳腺全容積成像技術(shù)　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過(guò)對(duì)比研究常規(guī)超聲檢查、自動(dòng)乳腺全容積成像技術(shù)(ABVS)及鉬靶(MG)檢查對(duì)乳腺腫物的診斷結(jié)果,評(píng)價(jià)ABVS對(duì)乳腺腫物的診斷價(jià)值。方法:選取2016年5月至12月在我院就診的120例女性患者,共156枚乳腺腫物,所有病例均取得穿刺及術(shù)后病理結(jié)果。先用常規(guī)超聲對(duì)雙側(cè)乳腺進(jìn)行掃查,記錄病灶的大小、形態(tài)、邊界、內(nèi)部回聲、有無(wú)鈣化,是否有后方衰減,并依據(jù)BI-RADS評(píng)估指標(biāo)進(jìn)行評(píng)級(jí),再用ABVS系統(tǒng)對(duì)雙側(cè)乳腺進(jìn)行全容積掃查,并對(duì)傳輸至工作站的圖片進(jìn)行分析,依據(jù)BI-RADS評(píng)估指標(biāo)進(jìn)行評(píng)級(jí),結(jié)合MG對(duì)乳腺腫物檢查的診斷結(jié)果,以病理結(jié)果為金標(biāo)準(zhǔn),采用χ2檢驗(yàn),比較常規(guī)超聲、ABVS和MG三種檢查的診斷效能,P0.05差異有統(tǒng)計(jì)學(xué)意義;Z檢驗(yàn)比較常規(guī)超聲、ABVS及MG的ROC曲線下面積;采用Kappa值就ABVS和MG對(duì)乳腺鈣化檢出一致性進(jìn)行評(píng)價(jià)。探討ABVS診斷乳腺腫物的臨床應(yīng)用價(jià)值。結(jié)果:(1)入選的120位女性患者,年齡23~78歲,平均(47.66±12.38)歲,良性病灶患者年齡為(40.75±11.14)歲,惡性病灶患者年齡為(52.77±11.42)歲,差異有統(tǒng)計(jì)學(xué)意義(t=5.977,P0.05);(2)腫瘤直徑0.4~6.1cm,平均(1.78±1.03)cm,良性病灶患者腫塊大小為(1.79±1.16)cm,惡性病灶患者腫塊大小為(1.76±0.90)cm,差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.873);(3)常規(guī)超聲診斷惡性腫瘤66例,病理證實(shí)83例(79%);診斷良性腫瘤53例,病理證實(shí)73例(72%)。常規(guī)超聲診斷乳腺腫物靈敏度為75.7%、特異度為76.0%、準(zhǔn)確度為75.8%。ABVS診斷惡性腫瘤81例,經(jīng)病理證實(shí)83例(97%);診斷良性腫瘤64例,經(jīng)病理證實(shí)73例(87%)。ABVS診斷乳腺腫物靈敏度為97.6%、特異度為87.7%、準(zhǔn)確度為92.9%。MG診斷惡性腫瘤67例,經(jīng)病理證實(shí)83例(80%);診斷良性腫瘤54例,經(jīng)病理證實(shí)73例(73%)。MG診斷乳腺腫物靈敏度為80.7%、特異度為74.0%、準(zhǔn)確度為77.6%。常規(guī)超聲與MG診斷乳腺腫物的靈敏度、特異度、準(zhǔn)確度差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。ABVS診斷乳腺腫物的靈敏度、特異度、準(zhǔn)確度均高于常規(guī)超聲,差異均有統(tǒng)計(jì)學(xué)意義(χ2=11.65、4.30、15.39,P0.05)。ABVS診斷乳腺腫物的靈敏度、準(zhǔn)確度均高于MG檢查,差異均有統(tǒng)計(jì)學(xué)意義(χ2=10.53、13.49,P0.05);兩者特異度比較差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=3.58,P=0.06)。(4)常規(guī)超聲、ABVS及MG的ROC曲線下面積分別為0.759、0.936、0.763;(5)匯聚現(xiàn)象診斷乳腺腫物靈敏度為44.9%、特異度為100%、準(zhǔn)確度為68.3%;(6)ABVS與MG對(duì)乳腺鈣化的診斷結(jié)果一致性較好(Kappa值=0.79,P0.05)。結(jié)論:ABVS獨(dú)特的三維成像技術(shù),乳腺的自動(dòng)全容積掃查,特有的冠狀面能夠清晰的顯示病灶,使病灶圖像更直觀,逼真,以提高檢查者診斷乳腺癌的準(zhǔn)確率;MG和ABVS兩種檢查方法對(duì)鈣化的檢出一致性好,ABVS有效的彌補(bǔ)了常規(guī)超聲在診斷鈣化方面的不足,有助于提高病變良惡性的診斷。相比常規(guī)超聲、MG對(duì)乳腺腫物診斷的靈敏度、準(zhǔn)確度更高,具有重要的臨床診斷價(jià)值。
[Abstract]:Objective: to study the diagnostic results of breast mass by conventional ultrasound, automatic full volume mammography (ABVS) and mammography (MG). To evaluate the value of ABVS in the diagnosis of breast masses. Methods: a total of 156 breast masses were selected from 120 female patients who were admitted to our hospital from May 2016 to December. The results of puncture and postoperative pathology were obtained in all cases. The bilateral mammary glands were scanned with conventional ultrasound to record the size, shape, boundary, internal echo, calcification and posterior attenuation of the lesions. According to the evaluation index of BI-RADS, the whole volume of bilateral mammary gland was scanned by ABVS system, and the images transmitted to workstation were analyzed. The image was rated according to the evaluation index of BI-RADS, and combined with the diagnostic result of MG for mammary gland mass examination. According to the pathological results as gold standard, 蠂 2 test was used to compare the diagnostic efficacy of conventional ultrasonography with ABVS and MG (P0.05). There was significant difference between Z test and conventional ultrasound under the ROC curve of ABVS and MG. Kappa value was used to evaluate the consistency of ABVS and MG in the detection of breast calcification. To explore the clinical application value of ABVS in the diagnosis of breast tumor. Results the age of 120 female patients with benign lesions was 47.66 鹵12.38 years old, and the age of benign lesions patients was 40.75 鹵11.14 years, the age of 120 female patients was 237.66 鹵12.38 years old, the age of the patients with benign lesions was 40.75 鹵11.14 years. The age of the patients with malignant lesions was 52.77 鹵11.42 years old. The difference was statistically significant (P < 0.05). The diameter of malignant lesions was 0.4 ~ 6.1cm (mean 1.78 鹵1.03cm), the size of benign lesions was 1.79 鹵1.16cm, and the size of malignant lesions was 1.76 鹵0.90cm. There was no significant difference between the two groups. 83 cases were proved by pathology, 53 cases were benign tumors, and 73 cases were confirmed by pathology. The sensitivity, specificity, accuracy, accuracy and pathology of conventional ultrasound in the diagnosis of breast masses were 75.75.7, 76.0, 75.8.ABVS, 83.83, respectively, and 64 cases of benign tumors were diagnosed. The sensitivity, specificity, accuracy, accuracy, pathology and pathology of 73 cases were 97.6, 87.7, 92.9.MG, 83 cases, 54 cases, respectively. The sensitivity, specificity and accuracy of routine ultrasound and MG in the diagnosis of breast masses were 80.7, 74.0 and 77.6.The sensitivity, specificity and accuracy of routine ultrasound and MG in the diagnosis of breast masses were not statistically significant. The specificity and accuracy were higher than those of conventional ultrasound, and the difference was statistically significant (蠂 ~ 2 11.65 ~ 4.30 ~ 15.39 ~ 15.39% P0.05U. ABVS) in the diagnosis of breast tumor. The accuracy of ABVS was higher than that of MG. The difference was statistically significant (蠂 ~ 2 / 10.53 ~ 13.49 / P 0.05), and there was no significant difference in specificity between the two groups (蠂 ~ (2) ~ (3.58)). The areas under the ROC curve of conventional ultrasound and MG were 0.759 ~ 0.93ng / 60.7635). The sensitivity, specificity, accuracy and accuracy of conventional ultrasound ABVS and MG in the diagnosis of breast masses were 44.9, 100 and 68.33A, respectively, and the area under the ROC curve was 0.759 and 0.930.7635 respectively. The diagnostic sensitivity was 44.9, the specificity was 100, and the accuracy was 68.33%. The diagnostic results of MG for breast calcification are in good agreement with the Kappa value of 0.79 and P0.05.Conclusion the special three-dimensional imaging technique of the 30% ABVS may be useful in the diagnosis of breast calcification. Automatic full volume scanning of mammary gland, unique coronal plane can clearly display the focus, making the focus image more intuitive and realistic, In order to improve the diagnostic accuracy of breast cancer in examiners, MG and ABVS can effectively compensate for the deficiency of conventional ultrasound in the diagnosis of calcification. It is helpful to improve the diagnosis of benign and malignant lesions. Compared with the conventional ultrasound MG, the sensitivity of the diagnosis of breast masses is higher and the accuracy is higher, which has important clinical value.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.1;R737.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳中將;;超聲彈性成像應(yīng)變率比值在乳腺良惡性腫塊中的鑒別診斷價(jià)值[J];中國(guó)基層醫(yī)藥;2016年07期

2 陳妮;黃曉玲;李茂萍;;乳腺良惡性病灶超聲造影特征表現(xiàn)[J];中華乳腺病雜志(電子版);2016年01期

3 ;中國(guó)抗癌協(xié)會(huì)乳腺癌診治指南與規(guī)范(2015版)[J];中國(guó)癌癥雜志;2015年09期

4 王正平;郭俏俏;黃必飛;樓琴;吳超;徐巧陽(yáng);;自動(dòng)乳腺全容積成像技術(shù)對(duì)乳腺腫塊大小的評(píng)估[J];中華醫(yī)學(xué)超聲雜志(電子版);2015年06期

5 冷曉玲;黃國(guó)福;馬富成;;乳腺癌病灶大小與超聲造影表現(xiàn)的相關(guān)性[J];中華超聲影像學(xué)雜志;2015年04期

6 蘇昆侖;徐海濱;張正賢;涂美琳;郝亮;胡祖健;何俊玲;楊歐歐;羅華;楊慧芬;劉玲琳;;自動(dòng)乳腺全容積掃查系統(tǒng)對(duì)致密乳腺中乳腺癌的診斷價(jià)值[J];中華超聲影像學(xué)雜志;2015年01期

7 張麗丹;包凌云;張麗;;ABVS在乳腺多發(fā)結(jié)節(jié)中偶發(fā)癌的診斷價(jià)值[J];中國(guó)超聲醫(yī)學(xué)雜志;2014年07期

8 蔣s，

本文編號(hào)：1483525