多模态超声定位引导乳腺导管内癌活检的临床价值

发布时间：2018-03-26 20:04

本文选题：乳腺导管内癌　切入点：多模态超声　出处：《广西医科大学》2017年硕士论文

【摘要】：目的:通过分析乳腺导管内癌的多模态超声表现,评价多模态超声检查对乳腺导管内癌的应用价值;探讨多模态超声定位引导乳腺导管内癌活检的临床价值。方法:回顾性分析2014年8月至2017年1月在广西医科大学附属肿瘤医院乳腺外科住院在多模态超声定位引导活检的75例乳腺导管内癌患者75个病灶的临床资料及病理组织学诊断结果,均为女性,年龄26-70岁,平均年龄(47.38±11.01)岁。活检前行多模态超声(常规超声、彩色多普勒超声、萤火虫技术、全景成像技术、弹性成像技术)检查。75例乳腺导管内癌患者均在多模态超声定位引导活检,活检标本进行病理检查。借鉴ACR提出的BI-RADS分类规范记录评分,对检查结果做出初步分类;病灶血供分级参照Alder半定量法;弹性评分参考罗葆明改良5分法;采用SPSS 19.0统计软件进行数据统计,采用Pearson相关分析进行相关分析,以P0.05为差异有统计学意义。结果:1、DCIS多模态超声分类肿块型72例,其中伴微钙化47例,单纯钙化型3例。BI-RADS 4类为69例,占92.00%(69/75),3例为BI-RADS3类,占4.00%(3/75),BI-RADS 0类为3例,占4.00%(3/75)。肿块型中平行生长为72例,占100.00%(72/72);形态不规则为69例,占95.83%(69/72);边缘不完整为65例,占90.28%(65/72);伴有微钙化为47例,占65.28%(47/72);后方回声衰减为15例,占20.83%(15/72);血供丰富为54例,占75.00(54/72);UE评分4分为64例,占88.89%(64/72),结果提示DCIS以质软为主;多模态超声测量DCIS病灶直径与术后大体病灶直径的相关系数为0.948,有统计学意义(P=0.000)。2、72例肿块型采用多模态超声定位引导穿刺活检,均一次性取材成功取得病理结果,无明显并发症发生;3例单纯微钙化型采用多模态超声引导钢丝定位手术活检,均一次性取材成功取得病理结果,无钢丝移位、折断、脱落。活检病理结果DCIS-MI为30例,占40.00%(30/75),DCIS为45例,占60.00%(45/75)。结论:1、DCIS多模态超声多表现为平行生长、形态不规则、边缘不完整、伴有微钙化、血供丰富及病灶质软,提高对DCIS的认识对其早期诊断具有重要的指导意义和应用价值。2、多模态超声定位引导DCIS活检,取材成功率高,有助于DCIS的早期诊断。
[Abstract]:Objective: to evaluate the value of multimodal ultrasonography in breast intraductal carcinoma by analyzing its findings. Objective: to evaluate the clinical value of multimodal ultrasound guided biopsy of breast intraductal carcinoma. Methods: retrospective analysis was conducted in breast surgery hospital affiliated to Guangxi Medical University from August 2014 to January 2017. Clinical data and histopathological diagnosis of 75 lesions in 75 patients with breast intraductal carcinoma. All of them were female, aged 26 to 70 years, with an average age of 47.38 卤11.01 years. Multimodal ultrasound (conventional ultrasound, color Doppler ultrasound, firefly technique, panoramic imaging) was performed before biopsy. All the 75 cases of breast intraductal carcinoma were examined by multi-mode ultrasound guided biopsy, and the biopsy specimens were examined by pathology. The results were preliminarily classified according to the score of BI-RADS classification standard put forward by ACR. According to Alder semi-quantitative method, elastic score reference Luo Baoming's improved 5-score method, SPSS 19.0 statistical software was used for data statistics, and Pearson correlation analysis was used for correlation analysis. Results there were 72 cases of mass type with microcalcification, 69 cases with BI-RADS 4, 3 cases with BI-RADS 4, 3 cases with BI-RADS3, and 3 cases with 4.000.75% BI-RADS 0. There were 72 cases of parallel growth in mass type, accounting for 100.007 / 72% of 72 cases; 69 cases of irregular shape, accounting for 95.83% of 72%; 65 cases of marginal incompleteness, accounting for 90.28% of 6572%; 47 cases of microcalcification with microcalcification, accounting for 65.28% of 47%; 15 cases of back echo attenuation, accounting for 20.833% -72%; 54 cases of abundant blood supply. The UE score of 75.00 / 54 / 72 was divided into 64 cases, accounting for 88.89% and 64% of 72%. The results showed that the quality of DCIS was mainly soft. The correlation coefficient between the diameter of DCIS lesion and the diameter of gross lesion after operation was 0.948 by multimodal ultrasound. There was statistical significance in 72 cases of mass type guided by multi-mode ultrasound, and the pathological results were obtained successfully in one time. There were no obvious complications in 3 cases of simple microcalcification with multi-mode ultrasound guided steel wire localization biopsy. The pathological results were obtained successfully in one time, no steel wire displacement, fracture, and exfoliation. The pathological results of biopsy were DCIS-MI in 30 cases. There were 45 cases with DCIS of 30% of 45% (60.005 / 75%). Conclusion the multimodal ultrasound of 10: 1 is characterized by parallel growth, irregular shape, incomplete margin, microcalcification, abundant blood supply and soft lesions. Improving the understanding of DCIS has important guiding significance and application value for early diagnosis. Multi-mode ultrasound guided DCIS biopsy is helpful to the early diagnosis of DCIS.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R737.9

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