声脉冲辐射力成像在腮腺局灶性病变中的应用

发布时间：2018-03-20 14:10

本文选题：声辐射力脉冲成像　切入点：声触诊组织量化技术　出处：《皖南医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究的目的是评估超声弹性成像声辐射力脉冲(ARFI)技术诱导的声触诊组织定性成像(VTI)和声触诊组织定量技术(VTQ)对于诊断腮腺局灶性病变的价值。方法:选取我院口腔颌面外科因腮腺局灶性病变住院的59例患者,术前分别进行常规超声、ARFI成像,对腮腺病变的二维超声图像特征及血流信号特征进行分析;对病变及周围正常组织进行VTI检查,获得黑白灰阶图像,采用VTI六级评分法;对病灶行VTQ检查记录剪切波速度(SWV)。绘制VTI分级、SWV的受试者操作特性曲线(ROC),找出VTI、VTQ诊断腮腺局灶性病变的最佳临界值。以术后病理结果为金标准,比较常规超声、VTI、VTQ对腮腺局灶性病变的鉴别诊断价值。结果:以腮腺术后病理结果为金标准,59个腮腺病变中45个为良性,14个为恶性。(1)常规超声的声像图特征:形状、边缘、病变组成、回声结构、回声反射性、有无钙化、后方回声增强及血流情况在良、恶性病变中差异无统计学意义;(2)VTI的ROC曲线下面积为0.813,VTI诊断腮腺局灶性病变的敏感度、特异度、准确度分别为78.6%、82.2%、81.4%;(3)VTQ的ROC曲线下面积为0.782,鉴别诊断腮腺局灶性病变的SWV值最佳临界点为3.89m/s,敏感度、特异度、准确度分别为64.3%、86.7%、81.4%。结论:(1)腮腺良、恶性病灶的VTI分级差异有统计学意义,良性病灶多在I~III级,恶性病灶多在IV~VI级;(2)腮腺良、恶性病灶的SWV值差异有统计学意义,SWV值最佳临界点为3.89m/s,良、恶性病灶的SWV值存在部分重叠,多形性腺瘤与恶性病灶差异无统计学意义;(3)腮腺多形性腺瘤的SWV值高于腺淋巴瘤,故多形性腺瘤的硬度大于腺淋巴瘤;(4)VTI和VTQ两种方法诊断腮腺局灶性病变无统计学差异。
[Abstract]:Objective: to evaluate the diagnostic value of acoustic palpation tissue qualitative imaging (VTI) and acoustic palpation tissue quantitative technique (VTQ) induced by ultrasonic elastic imaging power pulse ARFI technique in the diagnosis of focal lesions of parotid gland. Methods: to evaluate the diagnostic value of acoustic palpation tissue qualitative imaging (VTI) and acoustic palpation tissue quantitative technique (VTQs) in the diagnosis of parotid gland focal lesions. A total of 59 patients with focal parotid lesions in oral and maxillofacial surgery in our hospital were selected. The features of two-dimensional ultrasound image and blood flow signal of parotid gland lesions were analyzed before operation, and the lesions and surrounding normal tissues were examined by VTI, and black and white gray-scale images were obtained by VTI six-grade scoring method. The shear wave velocities were recorded by VTQ. The operating characteristic curve of subjects with VTI grade was drawn to find out the best critical value of VTQ for the diagnosis of focal parotid lesions. The postoperative pathological results were taken as the gold standard. The value of VTQ in differential diagnosis of focal parotid lesions was compared. Results: according to the pathological results of parotid gland operation, 45 of 59 parotid lesions were benign and 14 were malignant. There was no significant difference between benign and malignant lesions in the composition of lesions, echo structure, echo reflex, calcification, posterior echo enhancement and blood flow. The area under the ROC curve of VTI was 0.813 and the sensitivity and specificity of VTI in the diagnosis of focal parotid lesions were not significant. The area under the ROC curve of VTQ was 0.782.The best critical point of SWV value for differential diagnosis of focal parotid lesions was 3.89 mSs, the sensitivity, specificity and accuracy were 64.3ms.Conclusion there were significant differences in VTI grading between benign and malignant lesions of parotid gland and parotid gland with accuracy of 82.2and 0.782.Conclusion there is a significant difference in VTI grade between benign and malignant lesions of parotid gland, and the best critical point for differential diagnosis of parotid focal lesions is 3.89 mSs, and the sensitivity, specificity and accuracy are 64.3ms. Most benign lesions were in grade Ig III, and most of malignant lesions were in grade IV~VI. The difference of SWV in malignant lesions was statistically significant. The best critical point of SWV was 3.89 m / s. The SWV values of benign and malignant lesions were partially overlapped. The SWV value of pleomorphic adenoma was higher than that of adenomatous lymphoma, so the hardness of pleomorphic adenoma was higher than that of adenomatous adenoma and VTQ.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R739.87

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