乳腺全容积成像技术在乳腺良恶性疾病诊断中的临床价值研究

发布时间：2018-04-17 06:55

本文选题：乳腺全容积成像技术 + 乳腺超声　；参考：《大连医科大学》2016年硕士论文

【摘要】：目的:1.通过对乳腺肿物进行ABVS(Automated Breast Volume Scan)乳腺自动全容积成像技术检查,探讨ABVS检查对乳腺良性、恶性肿物诊断的准确性、特异性及敏感性。2.探讨ABVS检查对乳腺良、恶性疾病诊断的影像学特点及诊断意义。3.探讨ABVS检查的特征与乳腺恶性肿瘤临床病理特征的关联性。方法:收集大连医科大学附属第一医院2015年1月~2016年1月乳腺外科收治的乳腺肿瘤患者病案资料,收集患者在我院进行ABVS检查的数据资料,建立数据库。进行手术病理检查明确患者纳入统计。共496例,528枚肿物,平均年龄(47.08±13.92)岁。将临床资料收集整理后输入于Filemaker Pro13.0建立的数据库进行各因素分类、分组。进行统计分析。计算ABVS对乳腺肿瘤诊断的准确性、敏感性、特异性。统计采用SPSS(statistical package for the social sciences)22.0软件,以P0.05作为具有显著性差异的评判标准。结果:1、ABVS检查对乳腺良性、恶性肿物诊断的准确性:(1)从超声形态上,鉴别良恶性肿瘤的特异度(82.97%)、敏感度(73.62%),符合率(87.54%)。(2)从超声饱满度上,鉴别良恶性肿瘤的特异度(86.54%)、敏感度(91.25%),符合率(80.21%)。(3)从超声边界上,鉴别良恶性肿瘤的特异度(81.54%)、敏感度(86.23%),符合率(83.65)%。(4)从超声边缘上,鉴别良恶性肿瘤的特异度(84.52%)、敏感度(94.15)%,符合率(82.21%)。(5)从超声回声上,鉴别良恶性肿瘤的特异度(86.54%)、敏感度(81.42%),符合率(86.54%)。(6)从超声是否伴有微钙化上,鉴别良恶性肿瘤的特异度(81.52%)、敏感度(87.85%),符合率(87.74%)。(7)从超声是否伴有血流上,鉴别良恶性肿瘤的特异度(86.52%)、敏感度(92.45%),符合率(89.54%)。(8)从ABVS横断面边缘上,鉴别良恶性肿瘤的特异度(91.65%)、敏感度(90.12%),符合率(92.52%)。(9)从ABVS冠状面上,鉴别良恶性肿瘤的特异度(92.52%)、敏感度(93.13%)符合率(92.54),准确指数(0.54)。2、乳房恶性肿瘤患者病理特征与ABVS影像特点之间关联性如下:1、ER与形态、边界、饱满、边缘、微钙化、汇聚征有关,P0.05差异有统计学意义;2、PR与形态、边界、饱满、边缘、微钙化、汇聚征、血流有关,P0.05差异有统计学意义;3、HER-2与形态、饱满、边缘有关,P0.05差异有统计学意义;4、CK5/6与形态、边界、饱满、微钙化有关P0.05差异有统计学意义;5、EGFR与形态、饱满、微钙化、汇聚征有关,P0.05差异有统计学意义;6、软组织浸润与边界、饱满、边缘有关,P0.05差异有统计学意义。结论:1、应用ABVS进行乳腺肿物检查所呈现的各声像学特征,尤其是冠状面特征,对鉴别良恶性肿瘤的特异度、敏感度、符合率均较高。因此将乳腺全容积成像技术应用在乳腺良恶性疾病诊断过程中具有较高的应用价值,可将其视为乳腺良恶性疾病的有效诊断措施。2、乳房恶性肿瘤患者病理特征与ABVS影像特点之间有一定关联性。对患者预后有一定提示。
[Abstract]:Purpose 1.The accuracy, specificity and sensitivity of ABVS(Automated Breast Volume scan in the diagnosis of benign and malignant breast masses were discussed.To explore the imaging features and diagnostic significance of ABVS in the diagnosis of benign and malignant breast diseases.To explore the correlation between the features of ABVS and the clinicopathological features of breast malignant tumors.Methods: the medical records of breast tumor patients admitted in the first affiliated Hospital of Dalian Medical University from January 2015 to January 2016 were collected. The data of ABVS examination were collected and the database was established.The patients were included in the statistics by surgical and pathological examination.The mean age was 47.08 卤13.92 years.The clinical data were collected and sorted into the database established by Filemaker Pro13.0.Carry on statistical analysis.The accuracy, sensitivity and specificity of ABVS in the diagnosis of breast tumors were calculated.SPSS(statistical package for the social sciences)22.0 software was used, and P0.05 was taken as the criterion of significant difference.Results the diagnostic accuracy of the ABVS examination for benign and malignant breast masses was 82.97%, 73.62%, 82.97%, 73.62% and 87.54%, respectively.) from the aspect of ultrasound, the accuracy of the diagnosis of benign and malignant breast masses was 82.97%, and the coincidence rate was 87.54%. (2) from the aspect of ultrasonic plumpness, the accuracy of ABVS in the diagnosis of benign and malignant breast masses was 82.97%.The specificity of differentiating benign and malignant tumors is 86.54. The sensitivity is 91.250.The coincidence rate is 80.21. From the boundary of ultrasound, the specificity of differentiating benign and malignant tumors is 81.54. The sensitivity is 86.23. The coincidence rate is 83.65.The specificity of differentiating benign and malignant tumors is 84.52 and the sensitivity is 94.15. The coincidence rate is 82.21. On the echo of ultrasound, the specificity of benign and malignant tumors is 86.54. The sensitivity is 81.42. The coincidence rate is 86.54.The specificity of differentiating benign and malignant tumors was 81.52 and the sensitivity was 87.855.The coincidence rate was 87.747.740.The specificity of ultrasound was 86.52%, and the sensitivity was 92.455.The coincidence rate was 89.540.88) from the edge of ABVS cross section.The specificity of the differential diagnosis of benign and malignant tumors was 91.65%, the sensitivity was 90.12%, the coincidence rate was 92.522%) from the coronal plane of ABVS,The specificity of differential diagnosis of benign and malignant tumors was 92.52% and sensitivity was 93.13%.) the coincidence rate was 92.54 and the accurate index was 0.54. The correlation between pathological features and ABVS imaging features of breast malignant tumors was as follows: 1 / 1 ER and morphology, boundary, fullness, margin, microcalcification, and microcalcification.There were significant differences in convergence sign (P0.05) between PR and morphology, border, fullness, edge, microcalcification, convergence sign, blood flow related difference (P0.05). There was significant difference between HER-2 and shape, fullness, and significant difference in edge (P 0.05) about CK5 / 6 and morphology.There were significant differences in the boundary, fullness, microcalcification (P0.05) and morphology (P0.05), plump, micro-calcification (P05), convergence (P0.05), soft tissue infiltration and boundary, fullness (P0.05), edge (P0.05).Conclusion the sonographic features, especially the coronal features, of ABVS for breast mass examination are of high specificity, sensitivity and coincidence in differentiating benign and malignant tumors.Therefore, the application of full volume mammography in the diagnosis of benign and malignant breast diseases has a higher application value.It can be regarded as an effective method for the diagnosis of benign and malignant breast diseases. There is a certain correlation between the pathological features of breast malignant tumors and the features of ABVS images.There are some indications for the prognosis of the patients.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R445.1;R737.9

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