三维增强乳腺断层摄影及全数字化平板乳腺检查对乳腺微小簇状钙化诊断的对比研究

发布时间：2018-03-19 15:43

  本文选题：乳腺微小簇状钙化灶　切入点：三维增强断层乳腺摄影　出处：《山西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：研究背景：乳腺X线检查目前被公认为是乳腺癌的首选检查方式，特别对早期乳腺癌的诊断更具优势。标准化2D乳房X线造影术受限于乳腺组织重叠，容易受到隐藏癌症病灶的干扰或将正常组织视为异常。近年来影像设备不断更新，三维增强乳腺断层摄影(Digital breast tomosynthesis，DBT)的出现，使乳腺癌病变X线征象显示清晰度有了明显的提高，临床诊治早期乳腺癌所占比例明显增大。三维增强乳腺断层摄影(DBT)能够克服全数字化乳腺摄影(FFDM)因组织重叠而影响病变观察的问题，，降低复检率，减少不必要的活检，提高癌灶的检出率。对于致密型乳腺，DBT可以减少“假阳性”的检出。 目的：通过比较三维增强断层乳腺钼靶与全数字化平板乳腺检查这两种方法在乳腺微小簇状钙化诊断中诊断结果阳性率、平均阅片时间和定位准确性方面的差异，为临床提供更优化的检查手段，以期提高乳腺微小簇状钙化诊断水平。方法：选取80例2012年9月至2013年12月期间山西省肿瘤医院乳腺科超声检查为阴性的住院患者，BIRADS Ⅳ级、体格检查阴性的住院病例，各40例，随机进行三维增强断层乳腺摄影（A组）与全数字化平板乳腺机钼靶X线检查（B组），诊断乳腺微小簇状钙化，使用巴德双钩定位针钼靶辅助下行乳腺微小簇状钙化定位并行手术治疗。采用SPSS13.0统计软件进行统计分析，评价两组在初始阅片时间、穿刺定位后病理诊断结果（阳性率）以及定位时的照射次数的差异。 结果：与全数字化平板乳腺机检查组比较，三维增强断层乳腺摄影检查组在诊断结果阳性率，平均阅片时间和定位时的照射次数方面的均存在显著性差异（P0.05），差异具有统计学意义。 结论：与全数字化平板乳腺检查比较，三维增强断层乳腺钼靶检查具有更高的诊断阳性率，且阅片时间更短，定位更准确，可以有效减低乳腺癌诊断的误诊率及漏诊率，建议可疑乳腺癌患者行三维增强断层钼靶检查或复查。
[Abstract]:Background: mammography is currently recognized as the preferred method for breast cancer, especially for the diagnosis of early breast cancer. Standardized 2D mammography is limited to overlapping breast tissue. It is easy to be disturbed by hidden cancer lesions or to regard normal tissue as abnormal. In recent years, the imaging equipment has been continuously updated, and the appearance of 3D enhanced mammography Digital breast tomosynthesisDBT (DBT) has significantly improved the clarity of X-ray signs of breast cancer. The proportion of clinical diagnosis and treatment of early breast cancer is obviously increased. Three-dimensional enhanced mammography (DBT) can overcome the problem that the tissue overlap of all digital mammography (FFDM) affects the observation of pathological changes, reduce the rate of re-examination and reduce the unnecessary biopsy. To improve the detection rate of breast cancer, DBT can reduce the false positive rate. Objective: to compare the difference between three dimensional enhanced tomography mammography and all digital flat mammary gland examination in the diagnosis of small cluster calcification of mammary gland, such as the positive rate of diagnosis, the average reading time and the accuracy of localization. In order to improve the diagnostic level of breast microcluster calcification, 80 patients with negative breast ultrasound examination from September 2012 to December 2013 in Shanxi Cancer Hospital were selected as BIRADS 鈪

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