超声实时弹性成像和“萤火虫”技术联合诊断乳腺良恶性病灶的价值研究

发布时间：2018-04-27 01:00

本文选题：乳腺病变 + 超声检查　；参考：《新乡医学院》2017年硕士论文

【摘要】：目的:分析超声实时弹性成像整体应变率比值和局部应变率比值诊断乳腺良恶性病灶的最佳临界值,比较超声实时弹性成像整体应变率比值和局部应变率比值的诊断价值,并与超声“萤火虫”技术诊断结果进行比较,探讨超声“萤火虫”技术联合超声实时弹性成像诊断乳腺良恶性病灶的价值和意义,为提高超声对乳腺良恶性病灶的鉴别诊断水平提供参考和帮助。方法:选取于2015年6月~2016年6月因乳房肿块就诊的94例女性患者为研究对象,经病理确诊为良性病灶74个,恶性病灶30个。均采用东芝Aplio500彩色多普勒超声检测仪分别以超声实时弹性成像和“萤火虫”技术进行病灶检查,以病理结果为金标准,绘制ROC曲线,并以曲线下面积(Area under Curve,AUC)比较局部应变率比值、整体应变率比值诊断乳腺良恶性病灶的结果。分别采用“萤火虫”技术、超声实时弹性成像技术和两种技术联合检测对乳腺肿块进行检查,以病理结果为金标准进行比较,比较不同检查方式诊断乳腺良恶性病灶的准确性、特异性和敏感性。结果:良性病灶局部应变率比值和整体应变率比值均低于恶性病灶,比较差异均具有统计学意义(P0.05)。局部应变率比值和整体应变率比值的AUC分别为0.92和0.85,最佳临界点为31.14和3.14,两者诊断乳腺良恶性病灶的敏感度、特异度、准确性分别为84.6%、80.0%、86.5%和69.2%、63.3%、71.6%。局部应变率比值对乳腺良恶性病灶的诊断价值优于整体应变率比值,比较具有统计学差异(P0.05)。超声“萤火虫”技术和实时弹性成像诊断良恶性病灶的准确性、特异度及敏感度分别为86.5%、80.0%、89.2%和84.6%、76.7%、87.8%,两者联合检测的准确性、特异度及敏感度分别为96.2%、93.3%、97.3%。“萤火虫”技术诊断、超声实时弹性成像诊断的敏感度和准确性均高于钼靶X线摄影技术,特异度低于钼靶X线摄影技术,但比较差异均无统计学意义(P0.05)。联合检测的准确性、敏感度与超声“萤火虫”技术、实时弹性成像诊断和钼靶X线摄影技术比较均具有统计学差异(P0.05),联合检测的特异度最高,但与超声“萤火虫”技术和实时弹性成像检测的特异度比较均无统计学差异(P0.05)。结论:超声实时弹性成像整体应变率比值和局部应变率比值对乳腺良恶性病灶均有重要的诊断价值,其中局部应变率比值的诊断价值更高,优于整体应变率比值的诊断价值;联合超声实时弹性成像和“萤火虫”技术对乳腺良恶性病灶进行诊断,准确性、特异度及敏感度明显提高,具有较高的诊断价值。
[Abstract]:Objective: to analyze the optimal critical value of the ratio of global strain rate and local strain rate for diagnosis of benign and malignant breast lesions, and to compare the diagnostic value of the ratio of global strain rate and local strain rate in real-time ultrasound elastography. Compared with the diagnostic results of ultrasonic "firefly" technique, the value and significance of ultrasonic "firefly" technique combined with ultrasound real-time elastic imaging in the diagnosis of benign and malignant breast lesions were discussed. To improve the ultrasonic diagnosis of benign and malignant breast lesions to provide reference and help. Methods: 94 female patients with breast masses from June 2015 to June 2016 were selected as study subjects. 74 benign lesions and 30 malignant lesions were confirmed by pathology. Toshiba Aplio500 color Doppler ultrasound instrument was used to detect the lesions by real-time elastic imaging and "firefly" technique, and the ROC curve was drawn according to the pathological results as gold standard. The local strain rate ratio and the global strain rate ratio were compared with the area under current ratio under the curve for the diagnosis of benign and malignant breast lesions. Firefly technique, real-time elastography and two techniques were used to detect breast masses respectively. The accuracy of different examination methods in the diagnosis of benign and malignant breast lesions was compared by using pathological results as gold standard. Specificity and sensitivity. Results: the ratio of local strain rate and global strain rate of benign lesions was lower than that of malignant lesions, and the difference was statistically significant (P 0.05). The AUC of local strain rate ratio and global strain rate ratio were 0.92 and 0.85, respectively, and the best critical points were 31.14 and 3.14 respectively. The sensitivity, specificity and accuracy of the local strain rate ratio and the global strain rate ratio in the diagnosis of benign and malignant breast lesions were 84.6% and 63.3%, respectively. The value of local strain rate ratio in the diagnosis of benign and malignant breast lesions was better than that of overall strain rate ratio, and the difference was statistically significant (P 0.05). The accuracy, specificity and sensitivity of ultrasonic "firefly" technique and real time elastic imaging in the diagnosis of benign and malignant lesions were 86.50.The specificity and sensitivity were 86.2% and 84.6%, respectively. The accuracy, specificity and sensitivity of the combined detection were 96.2% and 93.3%, respectively. The diagnostic sensitivity and accuracy of "Firefly" technique was higher than that of molybdenum target radiography, and the specificity was lower than that of molybdenum target radiography, but there was no significant difference between them. The accuracy and sensitivity of the combined detection were significantly different from those of the ultrasonic "firefly" technique, real-time elastic imaging diagnosis and mammography. The specificity of the combined detection was the highest. But there was no significant difference between the specificity of ultrasonic firefly and real-time elastic imaging. Conclusion: the ratio of global strain rate and local strain rate in real-time ultrasound imaging has important diagnostic value for benign and malignant breast lesions, and the value of local strain rate ratio is higher than that of global strain rate ratio. Combined with real-time elastography and firefly technique, the accuracy, specificity and sensitivity of the diagnosis of benign and malignant breast lesions are significantly improved, which is of great value in the diagnosis of benign and malignant breast lesions.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R737.9

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