超声自动乳腺全容积成像在乳腺肿瘤诊治中的初步应用

发布时间：2018-03-10 11:46

本文选题：乳腺肿瘤　切入点：超声自动全容积成像　出处：《遵义医学院》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨超声自动乳腺全容积成像（ABVS）对乳腺肿瘤的临床诊治价值，并与手持超声（HHUS）检查结果进行比较。方法：将128例患者共130个乳腺肿瘤在术前接受ABVS和HHUS检查，以穿刺活检或手术病检结果为金标准，计算两者对乳腺肿瘤诊断的准确性、敏感性、特异性、阳性预测值、阴性预测值、阳性似然比、阴性似然比；以敏感性为纵坐标，以1-特异性为横坐标，做受试者工作特征曲线（ROC曲线），，计算曲线下面积（AUC）以评估两者的诊断价值；测量乳腺恶性肿瘤病灶最大径并与手术病理测量结果进行对比，比较ABVS与HHUS对乳腺癌病灶的检测情况。并用Kappa系数评估两种检查方法在各项相关因素（形状、方位、边缘、边境、内回声等）中的一致性。结果：ABVS对乳腺肿瘤诊断的准确性、敏感性、特异性、阳性预测值、阴性预测值、阳性似然比、阴性似然比分别为95.4%、94.6%、96.4%、97.2%、93.1%、26.28、0.06，HHUS为89.2%、90.5%、87.5%、90.5%、87.5%、7.24、0.11，两者间差异存在统计学意义（χ2=68.532,P=0.00）；乳腺恶性肿瘤患者ABVS及HHUS测量结果与病理学结果呈显著正相关（r=0.757,0.679,均P0.01）,ABVS测量结果与病理学测量结果之间的相关系数要高于HHUS（0.757VS0.679）；两种检查方法在肿瘤的形状（K=0.601）、方向（K=0.602）、边缘（K=0.735）、边境（K=0.658）、内部回声特点（K=0.731）、后方回声特点（K=0.676）、钙化（K=0.620）及BI-RADS分级（K=0.700）中具有较好的一致性。结论：ABVS能为乳腺肿瘤提供更多的诊断信息，从而提高乳腺肿瘤诊断的准确性；可以较清晰地显示出乳腺肿瘤病灶范围，对临床评估乳腺恶性肿瘤病灶大小有较大的参考价值。
[Abstract]:Objective: to evaluate the clinical value of automatic breast volume imaging (ABVS) in the diagnosis and treatment of breast neoplasms, and to compare the results with HHUS. Methods: a total of 130 breast tumors were examined by ABVS and HHUS before operation. The accuracy, sensitivity, specificity and positive predictive value were calculated according to the results of biopsy or surgical examination. Negative predictive value, positive likelihood ratio, negative likelihood ratio, sensitivity as ordinate, 1- specificity as horizontal coordinate, ROC curve of subjects operating characteristic curve and area under curve were calculated to evaluate their diagnostic value. The maximum diameter of breast cancer lesions was measured and compared with the results of surgical and pathological measurements. The detection of breast cancer lesions by ABVS and HHUS was compared. The Kappa coefficient was used to evaluate the relative factors (shape, orientation, edge). Consistency in borders, internal echoes, etc. Results: the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio of the diagnosis of breast tumor were measured by the weight ABVS, the diagnostic accuracy, sensitivity, specificity, positive predictive value, positive likelihood ratio, The negative likelihood ratio was 95.44 / 94.96. 4 / 97.2and 93.1 / 26.28 / 0.06 HHUS was 89.20.92 / 90.575 / 87.5 / 87.240.11, respectively. There was a significant difference between them (蠂 2 68.532P 0.009; the results of ABVS and HHUS in breast cancer were positively correlated with pathological results rr 0.7570.79), both P0.01s and pathology were significantly correlated with the results of ABVS and pathology (P < 0.05). The number of relationship was higher than that of HHUS0.57VS0.6790.The two methods had good consistency in the shape of the tumor, the direction of the tumor was 0.602, the edge was 0.735, the border was 0.658, the internal echo was 0.731C, the posterior echo was K0.676676, the calcification was 0.620) and the BI-RADS grade was 0.700). Provide more diagnostic information, So as to improve the diagnostic accuracy of breast tumors. It can clearly show the extent of breast tumor and has great reference value for clinical evaluation of the size of breast malignant tumor.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.9;R445.1

【参考文献】