X线滚动位结合点压放大摄影对乳腺疾病诊断的应用研究

发布时间：2018-04-12 07:41

本文选题：全数字化乳腺X线摄影 + 点压放大　；参考：《内蒙古大学》2017年硕士论文

【摘要】：X线检查是乳腺疾病筛查及诊断的首选检查方法,多种投照体位相结合在乳腺X线检查可以提高诊断的敏感性及特异性。目的:探讨局部点压+滚动位摄影技术相结合对乳腺疾病诊断的作用。方法:选取共计125例行乳腺X线常规检查+局部点压放大+滚动位并经病理验证患者,其中查体可触及肿块患者79例,不可触及肿块患者46例,对患者图像进行对比性研究。结果:125例患者,其中乳腺癌66例,良性肿块30例,非典型性增生8例,乳腺增生21例。其中79例可触及肿块的患者行常规乳腺X线摄影的敏感性、特异性、约登指数分别为:70.0%、48.4%、0.184。常规乳腺X线摄影+点压放大的敏感性、特异性、约登指数分别为:84.8%、75.8%、0.606。常规乳腺X线摄影+摄点压放大+滚动位的敏感性、特异性、约登指数分别为:95.7%、93.9%、0.896。46例不可触及肿块的患者行常规乳腺X线摄影的敏感性、特异性、约登指数分别为:75.0%、55.6%、0.306。常规乳腺X线摄影+摄点压放大的敏感性、特异性、约登指数分别为:89.2%、88.9%、0.781.常规乳腺X线摄影+摄点压放大+滚动位的敏感性、特异性、约登指数分别为:92.9%、94.4%、0.873。针对79例查体可触及疑似肿块患者,常规摄影+点压放大摄影+滚动位,其灵敏性及特异性明显高于常规摄影及常规摄影+点压放大摄影,经统计学分析,具有统计学意义。46例查体不可触及肿块患者,常规摄影+点压放大摄影,其灵敏性及特异性明显高于常规摄影,经统计学分析,具有统计学意义;而同常规摄影+点压放大摄影+滚动位差距不大,经统计学分析,不具有统计学意义。结论:常规摄影+点压放大摄影+滚动位,对可触及疑似肿块的乳腺病变诊断优于单纯的常规摄影及常规摄影+点压放大,特别是对于在单一体位上显示的肿块以及在诊断时对肿块所累及的范围有疑问时,更具有价值。而在针对不可触及肿块的乳腺病变时,常规摄影+点压放大摄影+滚动位,与常规摄影+点压放大摄影对乳腺病变诊断帮助不大,而前两者均优于单纯的常规摄影。点压放大摄影对于不可触及的乳腺病变,特别是对微小钙化的性质的评估具有重要的价值,而滚动位在行点压放大摄影后对此类病变的价值相对较小。
[Abstract]:X-ray examination is the first choice for screening and diagnosis of breast diseases. The combination of multiple radiographic posture and mammography can improve the sensitivity and specificity of the diagnosis.Objective: to explore the role of local point pressure rolling-position photography in the diagnosis of breast diseases.Methods: a total of 125 patients were examined by routine mammography, including 79 patients with mass and 46 patients with untouchable mass. The image of the patients was compared.Results among 125 cases, 66 cases were breast cancer, 30 cases were benign mass, 8 cases were atypical hyperplasia, 21 cases were hyperplasia of mammary gland.The sensitivity and specificity of conventional mammography in 79 patients with palpable masses were 0.184, respectively.In conventional mammography, the sensitivity and specificity of dot pressure amplification were 75.80.606 and 0.606, respectively.The sensitivity and specificity of conventional mammography in magnifying the rolling position were 93.9 and 0.896.46, respectively. The sensitivity and specificity of conventional mammography were: 1 / 75.0 / 55.6and 0.306respectively.In conventional mammography, the sensitivity and specificity of point pressure amplification were 88.9% and 0.781respectively.In conventional mammography, the sensitivity and specificity of the point pressure amplification of the rolling position were 94.4% and 0.873, respectively.For 79 patients with suspected mass, the sensitivity and specificity of conventional point pressure amplification were significantly higher than that of conventional and conventional point pressure amplification.The sensitivity and specificity of conventional point pressure amplification photography were significantly higher than that of conventional photography.However, there is not significant difference between point pressure magnification and rolling position of conventional photography, which is not statistically significant by statistical analysis.Conclusion: the diagnosis of breast lesions with conventional point pressure magnification is superior to that of conventional radiography and conventional radiography in the diagnosis of breast lesions which can reach the suspected masses.Especially, it is more valuable to show the mass on the single body position and to question the extent of the mass involved in the diagnosis.In the case of untouchable breast lesions, the point pressure magnification of conventional photography is of little help to the diagnosis of breast lesions, and the former is better than that of simple conventional photography.Point-pressure magnification is of great value for the assessment of the nature of unreachable breast lesions, especially for micro-calcification, but the rolling position is of relatively little value to such lesions after point pressure amplification.
【学位授予单位】：内蒙古大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R816.4;R655.8

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