乳腺良性结节射频消融术后超声E成像评估及多因素影响研究

发布时间：2018-06-08 07:44

  本文选题：乳腺良性结节 + 超声弹性成像　； 参考：《大连医科大学》2017年硕士论文

【摘要】：乳腺纤维瘤等良性结节是女性常见乳腺疾病。超声引导下射频消融术是临床医生治疗此类疾病的主要方法之一。本研究运用超声E成像技术评估乳腺良性结节射频术后消融灶的吸收情况,并分析多种不同因素对消融灶吸收情况的影响,以期为临床提供更多治疗新信息。研究目的1.探讨超声引导下射频消融对治疗乳腺良性结节的有效性。2.探讨超声E成像评估乳腺良性结节射频术后消融灶吸收效果的的可行性。3.探讨不同临床因素与乳腺良性结节射频术后消融灶吸收情况的相关性。研究方法收集自2015年9月份起入我院三部超声科进行乳腺射频消融的38例患者,共99枚良性结节。根据乳腺生理分期,患者处于性成熟期(18～45岁)的结节62枚,处于更年期(45～52岁)结节24枚,处于绝经期(52岁以后)患者13枚。根据结节所在象限位置,位于外上象限的结节24枚,位于外下象限的结节19枚,位于内上象限的结节38枚,位于内下象限的结节18枚。根据结节大小,结节长径1cm 40枚,1cm结节长径3cm 59枚。分别对每个结节进行术前及术后每月一次的随访观察,为期12个月。在常规超声模式下,测量记录所有消融灶每个月的体积,并计算所有消融灶每个月的体积减小率(与术前相比);在超声E成像模式下测量记录所有消融灶每个月的弹性Ratio比值。分别比较:①术前及术后每个月所有消融灶体积大小和术后消融灶体积减小率的变化。② 术前及术后每个月所有消融灶弹性Ratio比值的变化,以及弹性Ratio比值变化与消融灶体积变化之间的相关性。③每个月消融灶体积减小率与结节大小、乳腺生理分期、象限之间的相关性。采用SPSS 17.0分析软件,数值以(均数±标准差)表示,运用重复测量方差分析、Pearson相关性分析及回归分析和独立样本t检验等统计学方法进行统计学分析。研究结果:1、术前与术后每个月所有消融灶体积之间的变化、消融灶体积减小率之间的变化比较差异有统计学意义(P0.05)。2、术前及术后每个月所有消融灶弹性Ratio比值之间的变化比较差异有统计学意义(P0.05)。弹性Ratio比值的变化与术后消融灶体积的变化存在相关性(P0.05)。3、每个月所有消融灶体积减小率与结节大小之间存在相关性(P0.05),与乳腺生理分期和乳腺象限位置之间并无相关性(P0.05)。结节长径1cm与1cm结节长径3cm的结节之间,比较术后消融灶体积减小率差异有统计学意义(P0.05)。4、术后8月后消融灶体积、消融灶体积减小率(与术前相比)及弹性Ratio比值的变化明显减小。结论:1、超声引导下射频消融术对乳腺良性结节的治疗具有有效性。2、超声弹性成像可作为评价乳腺良性结节射频术后消融灶吸收情况的可行性手段。超声弹性成像证明随着随访时间的延长,弹性Ratio比值先升高,后逐渐降低。3、结节大小是超声引导下乳腺良性结节射频术后消融灶吸收效果的影响因素,结节大者吸收较快。4、术后第8个月可以作为评价超声引导下乳腺良性结节射频术后吸收效果的一个关键月份。
[Abstract]:Benign nodules, such as mammary fibroma, are common breast diseases. Ultrasound guided radiofrequency ablation is one of the main methods for clinicians to treat such diseases. Ultrasound E imaging is used to assess the absorption of ablation foci after radiofrequency surgery for benign breast nodules and to analyze the effects of various factors on the absorption of the ablation foci. To provide more new information for clinical treatment. Objective 1. to explore the effectiveness of ultrasound guided radiofrequency ablation for the treatment of benign breast nodules: a study of the feasibility of ultrasonic E imaging in assessing the effect of radiofrequency ablation for benign breast nodules after radiofrequency ablation.3. to explore different clinical factors and absorption after radiofrequency ablation for benign breast nodules after radiofrequency operation..3. A total of 99 benign nodules were collected from 38 cases of breast radiofrequency ablation in three ultrasound departments of our hospital from September 2015. According to the physiological stages of the breast, 62 nodules were in the sexual maturity (18~45 years old), 24 in menopause (45~52 years old), 13 in the menopause (after 52 years of age). According to the quadrant position of the nodule, 24 nodules located outside the upper quadrant, 19 nodules located in the outer quadrant, 38 nodules in the upper quadrant, 18 in the inner and lower quadrant, 40 and 3cm 59, according to the size of the nodules, and the long diameter of 1cm nodules, respectively, for each nodule before and after a monthly follow-up observation, respectively, The volume of all ablation foci per month was recorded and the volume reduction rate of all ablation foci was calculated (compared with preoperative) under the conventional ultrasound mode. The elastic Ratio ratio of all ablation foci was recorded in the ultrasonic E imaging mode. The volume of all ablation foci was larger than that before and after the operation. Changes in the elastic Ratio ratio of all ablation foci before and after operation, and the correlation between the changes of the elastic Ratio ratio and the volume change of the ablation focus. (3) the correlation between the volume reduction rate of the ablation focus and the size of nodules, the physiological stages of the breast and the quadrant of the mammary gland each month. Using SPSS 17 The analysis software was used to perform statistical analysis with repeated measurements of variance analysis, Pearson correlation analysis and regression analysis and independent sample t test. The results were as follows: 1, the changes in the volume of all ablation foci before and after the operation, and the comparison of the volume reduction rate between the ablation foci before and after the operation. The difference was statistically significant (P0.05).2. There was a significant difference between the elastic Ratio ratio of all ablation foci before and after the operation (P0.05). There was a correlation between the changes of the ratio of elastic Ratio and the change of the volume of the ablation focus (P0.05).3, and there was a correlation between the reduction rate of the ablation range and the size of the nodules each month. There was no correlation between sex (P0.05) and breast physiological staging and breast quadrant position (P0.05). Between nodular length diameter 1cm and 1cm nodule long diameter 3cm nodules, there was a statistically significant difference (P0.05).4, the volume of ablation foci after August, the reduction rate of ablation foci (compared with preoperative) and the ratio of elastic Ratio. Conclusions: 1. Ultrasound guided radiofrequency ablation is effective in the treatment of benign breast nodules. Ultrasound elastography can be used as a feasible means to evaluate the absorption of benign breast nodules after radiofrequency ablation. Elastography shows that the ratio of elastic Ratio increases first and then gradually increases with the duration of follow-up. To reduce.3, the size of nodules is an influential factor in the absorption of radiofrequency ablation for benign breast nodules under ultrasound guidance. The large nodule absorbs fast.4, and eighth months after operation can be used as a key month to evaluate the absorption effect of ultrasonic guided breast benign nodules after radiofrequency operation.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R655.8
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本文编号：1995174