MRI动态增强与超声剪切波弹性成像对乳腺良恶性病变的诊断价值

发布时间：2018-01-04 11:05

本文关键词：MRI动态增强与超声剪切波弹性成像对乳腺良恶性病变的诊断价值　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨、比较动态增强磁共振成像扫描(dynamic contrast-enhanced MRI,DCE-MRI)与超声剪切波弹性成像(ultrasound shear wave elastrography,USWE)及其联合诊断对乳腺良恶性肿瘤的诊断价值,为临床提供影像学诊断依据。方法:收集2015年1月至2017年2月在山西医学科学院山西大医院乳腺疾病的患者,共收集69例患者的临床资料,部分患者为多发病灶,所以共收集73个乳腺病灶,对其进行回顾性分析。这些患者术前均分别行DCE-MRI与USWE检查,并与其最终经穿刺或手术获得的病理结果相比较,对其进行回顾性分析。其中,DCE-MRI采用Fischer’s评分法对乳腺病灶根据美国放射学会推荐的“乳腺影像报告和数据系统”(breast imaging reporting and data system,BI-RADS)进行分级,USWE弹性模量Emax诊断界值为70Kpa,采用χ2检验对上述两种独立诊断方法进行比较,DCE-MRI及USWE联合诊断则采用并联的方法。依据病理结果分别评价其诊断价值。结果:对73个病灶分为三组进行分析:DCE-MRI诊断组,USWE诊断组及DCE-MRI与SWE联合诊断组。DCE-MRI与USWE独立诊断相比较,χ2=0.083 P0.05,差异无统计学意义;通过与病理结果相比较,DCE-MRI诊断乳腺良恶性病变的灵敏度、特异性分别为:90.2%、81.20%,USWE的灵敏度、特异度分别为:82.9%、78.1%,两者联合诊断的灵敏度、特异度分别为92.7%、68.8%。结论:DCE-MRI及USWE诊断乳腺良恶性病变无差别,DCE-MRI及USWE诊断乳腺良恶性病变的灵敏度、特异度均较高,DCE-MRI及USWE联合诊断明显提高灵敏度,但特异性较低。
[Abstract]:Objective: to compare dynamic contrast-enhanced MRI with dynamic contrast-enhanced Mr imaging. DCE-MRI) and Ultrasound shear wave elastrography. The value of USWEand its combined diagnosis in the diagnosis of breast benign and malignant tumor. Methods: from January 2015 to February 2017, the clinical data of 69 patients with breast diseases in Shanxi Medical Academy Hospital were collected. Some of the patients had multiple lesions, so 73 breast lesions were collected and analyzed retrospectively. All of them were examined by DCE-MRI and USWE before operation. And compared with the final pathological results obtained by puncture or surgery, it was analyzed retrospectively. DCE-MRI uses Fischer's scoring method to evaluate breast lesions according to the "mammography reporting and data system" recommended by the American Society of Radiology (. Breast imaging reporting and data system. The diagnostic limit of Emax was 70 Kpa. 蠂 2 test was used to compare the above two independent diagnostic methods. The diagnostic value of DCE-MRI and USWE was evaluated according to pathological results. Results: 73 lesions were divided into three groups. There was no significant difference between the USWE diagnosis group and the DCE-MRI / SWE diagnosis group. DCE-MRI was compared with the independent diagnosis of USWE (蠂 20.083 P 0.05). The sensitivity of DCE-MRI in the diagnosis of benign and malignant breast lesions was compared with the pathological results. The specificity of DCE-MRI was 90.2% and 81.20% respectively. The specificity was 82.9% and 78.1%, respectively. The sensitivity and specificity of the combined diagnosis were 92.7% respectively. Conclusion there is no difference between DCE-MRI and USWE in the diagnosis of benign and malignant breast lesions. The sensitivity and specificity of DCE-MRI and USWE in the diagnosis of benign and malignant breast lesions are high. The combined diagnosis of DCE-MRI and USWE improved the sensitivity, but the specificity was low.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9;R445

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