二维超声与组织弹性成像在乳腺良恶性肿块中的联合应用价值

发布时间：2018-05-05 21:10

本文选题：超声组织弹性成像 + 乳腺肿块　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：通过测定乳腺肿块的二维超声（Two-dimensional Ultrasound）及超声组织弹性成像（Ultrasonicelastography，UE）参数，分析研究超声组织弹性成像（Ultrasonic elastography，UE）技术对乳腺肿块良恶性的诊断价值。资料与方法：选取我院乳腺外科2012年3月至2013年6月收治的76例就诊女患者为基础研究对象。所有入组对象均经病理证实，，76例患者中共106个乳腺肿块。研究对象中乳腺肿块最大直径均不足5.0cm，术前未接受任何化疗与放疗，均经常规二维超声（2D-US）进行检查，并切换到超声弹性成像模式，操作时将感兴趣区调节到大致肿块面积2倍左右，根据显示屏上的质量指数（QF），以QF＞50-75为图像质量可信的标准进行检查。术后均经病理结果对照。所得检测结果均进行3次重复检查、应用彩色多普勒血流成像（CDFI）、德国西门子公司的Acuson S2000超声诊断仪弹性成像检查并取肿瘤直径平均数进行统计，对所得乳腺肿块间数据进行统计学分析，采用X2检验，经SPSS14.0软件进行分析，结果以p＜0.05表示差异有统计学意义。结果 1106个乳腺肿块组织病理学金标准诊断结果：79个良性肿块，27个恶性肿块。 2常规二维超声诊断乳腺肿块良恶性的灵敏性为81.48%（22/27）、特异性68.35（%54/79）、准确性71.70%（76/106）、阳性预测值91.53%（54/59）、阴性预测值46.81%（22/47）。 3UE评分诊断79个良性病灶中，3级以下62个78.48%（62/79），4级以上17个21.52%（17/79）；27个恶性病灶中，3级以下5个18.52%（5/27），4级以上22个81.48%（22/27）。 4常规二维超声与UE联合诊断灵敏性92.59%（25/27）、特异性94.94%（75/79）、准确性96.23%（102/106）、阳性预测值97.40%（75/77）、阴性预测值86.21%（25/29）。结论： 1常规二维超声诊断、超声组织弹性成像评分、常规二维超声诊断联合超声组织弹性成像评分这三种方法对乳腺肿块良恶性的诊断均具有一定临床价值，但是单纯应用其中一种方法进行诊断乳腺肿块良恶性与敏感性之间差异无明显统计学意义（p＞0.05）。 2联合诊断对乳腺肿块良恶性的敏感性、准确性、特异性均显著高于单独应用2D及UE诊断结果。 3三种方法阳性预测值间有统计学意义（p＜0.05），但阴性预测值间无统计学意义（p＞0.05）。 4虽然超声组织弹性成像技术联合诊断方法在评定乳腺癌中有一定差异，但是其在诊断乳腺肿块的良恶性方面上价值是不可置疑的。
[Abstract]:Objective: By measuring the parameters of Two-dimensional Ultrasound and Ultrasound elastography in breast masses, the diagnostic value of ultrasonic elastography and ultrasonic elastography in diagnosis of breast masses was studied. Information and methods: From March 2012 to June 2013, 76 female patients in our department of breast surgery were selected as basic research objects. A total of 106 breast masses were confirmed by pathology in 76 patients. The maximum diameters of breast masses were less than 5.0 cm. No chemotherapy and radiotherapy were performed before the study. They were examined by conventional two-dimensional ultrasonography (2D-USS) and switched to the mode of ultrasound elastic imaging. During operation, the area of interest was adjusted to about 2 times of the area of the mass. According to the quality index on the display screen, QF > 50-75 was used as the reliable standard of image quality. Postoperative pathological results were compared. The results were all repeated three times. The color Doppler flow imaging (CDFI) and the Acuson S2000 ultrasonic diagnostic instrument of Siemens Company of Germany were used to examine the results of elastic imaging, and the mean diameter of the tumor was calculated. The data of breast masses were statistically analyzed by X2 test and analyzed by SPSS14.0 software. The results showed that the difference was statistically significant with p < 0. 05. Result The diagnostic results of 1106 breast masses were as follows: 79 benign masses and 27 malignant masses. 2the sensitivity of conventional two-dimensional ultrasound in the diagnosis of benign and malignant breast masses was 81.48 and 22 / 27, the specificity was 68.35 / T / 79, the accuracy was 71.70 / 106, the positive predictive value was 91.53 / 59 and the negative predictive value was 46.81 / 47. Of the 79 benign lesions diagnosed by 3UE score, 62 were below 78.48 and 17 were above 62 / 79 / 4, 17 / 21.52 / 79 / 79, and 5 of 27 malignant lesions were below grade 3 and 5 18. 52 / 27 / 4, 22 / 81.48 were 22 / 27 / 27. (4) the sensitivity of conventional two-dimensional ultrasound combined with UE is 92.599.25 / 27, the specificity is 94.94 and 75 / 79, the accuracy is 96.23 / 102 / 106, the positive predictive value is 97.40 / 77 and the negative predictive value is 86.21 / 25 / 29. Conclusion: 1 the three methods of conventional two-dimensional ultrasound diagnosis, ultrasonic tissue elastic imaging score and conventional two-dimensional ultrasound diagnosis combined with ultrasound tissue elastic imaging score have certain clinical value in the diagnosis of breast masses. However, there was no significant difference in sensitivity between benign and malignant breast masses by using one of the methods alone (P > 0.05). 2 the sensitivity, accuracy and specificity of combined diagnosis for benign and malignant breast masses were significantly higher than those for 2D and UE alone. 3There was significant difference between the positive predictive values of the three methods (p < 0.05), but there was no significant difference between the negative predictive values and the positive predictive values (P > 0.05). 4 although there are some differences in the diagnosis of breast cancer with ultrasonic tissue elastography, its value in the diagnosis of benign and malignant breast masses is indisputable.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.9;R445.1

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