自动乳腺全容积成像技术诊断乳腺病变

发布时间：2018-08-30 19:51

【摘要】：第一部分：ABVS与HHUS鉴别乳腺良恶性病变诊断价值的比较目的比较自动乳腺全容积成像技术(ABVS)与常规超声对乳腺良恶性病变的诊断价值。方法前瞻性研究213例患者共239个乳腺病变,并与手术病理对照,分别计算自动乳腺全容积成像技术(ABVS)与常规超声的诊断敏感性、特异性、正确性、阳性预测值及阴性预测值。诊断准确性再按病变大小进一步分类评估。结果239个乳腺病变中,良性154(64.4%)个,恶性85(35.6%)个。ABVS与常规超声对乳腺病变诊断价值的比较：敏感性(95.3%vs.90.6%),特异性(80.5%vs.82.5%),准确性(85.8%vs.85.3%),阳性预测值(73.0%vs.74.0%),及阴性预测值(93.3%vs.94.1%)。 ROC曲线下面积分别为0.948及0.928。结论虽然ABVS与HHUS对乳腺病变的诊断准确性无明显差异,但ABVS可提供新的诊断信息。ABVS可帮助区分真正的占位性病变与不均质的片状回声区,发现恶性病变的卫星灶,及更清晰的显示导管病变。ABVS有很好的临床应用前景。第二部分：乳腺病变ABVS超声图像的观察者间一致性研究目的回顾性评估超声医生使用三维乳腺超声特有的术语以及超声乳腺影像报告和数据系统(BI-RADS)术语描述和诊断自动乳腺容积技术(ABVS)超声图像的观察者间一致性。方法患者已提供知情同意书。2010年8月一12月,208位患者在仰卧位接受ABVS检查,数据自动存入ABVS工作站。2位超声医生通过ABVS工作站回顾性独立评估234个乳腺病变(病理已证实为148个良性病变和86个恶性病变)的超声图像。观察者不知道钼靶图像、病史和病理结果。通过Cohen's kappa statistic评估观察者间的差异。结果观察者间的一致性为病变周边回声(κ=0.42)、纠集征(κ=0.54)的中等,形态(κ=0.79),纵横比(κ=0.74),边缘(κ=0.76),回声(K=0.69),后方回声(κ=0.68),钙化(κ=0.71),最终诊断(κ=0.70)的良好。结论ABVS获取的乳腺病变超声图像评估重复性好,但病变周边回声以及冠状切面所特有的纠集征一致性中等。
[Abstract]:Part one: comparison of diagnostic value of ABVS and HHUS in differential diagnosis of benign and malignant breast lesions objective to compare the diagnostic value of automatic full volume imaging (ABVS) and conventional ultrasound in benign and malignant breast lesions. Methods the sensitivity, specificity, correctness, positive predictive value and negative predictive value of automatic full volume mammography (ABVS) and conventional ultrasound were calculated in a prospective study of 239 breast lesions. The diagnostic accuracy was further classified according to the size of the lesion. Results of 239 breast lesions, 154 (64.4%) were benign, 85 (35.6%) malignant. ABVS was compared with conventional ultrasound in the diagnosis of breast lesions: sensitivity (95.3vs.90.6%), specificity (80.5vs.82.5%), accuracy (85.8vs.85.3%), positive predictive value (73.0vs.74.0%), negative predictive value (93.3vs.94.1%). The areas under the ROC curve were 0.948 and 0.928 respectively. Conclusion although there is no significant difference between ABVS and HHUS in the diagnosis of breast lesions, ABVS can provide new diagnostic information. And more clearly display catheter lesions. ABVS has a good clinical application prospects. Part 2: Inter-observer consistency of ABVS ultrasound images of breast lesions objective to evaluate retrospectively the terms specific to the use of three-dimensional breast ultrasound by ultrasound doctors and the Ultrasound Breast Imaging reporting and data system (BI-RADS) Description and diagnosis of automatic mammary volume technique (ABVS) ultrasound images are consistent among observers. Methods informed consent was provided. 208 patients underwent ABVS examination in supine position from August to December 2010. The data were automatically stored in ultrasound images of 234 breast lesions (148 benign lesions and 86 malignant lesions confirmed by pathology) by retrospective and independent assessment of 234 breast lesions on ABVS workstation by 2. 2 ultrasound doctors through ABVS workstation. Observers do not know molybdenum target images, history, and pathological results. The differences between observers were assessed by Cohen's kappa statistic. Results the consistency among the observers was as follows: the peripheral echo of the lesion was 0.42, the collation sign was 0.54, the shape was 0.79, the aspect ratio was 0.74, the margin was 0.76, the echo was 0.69, the posterior echo was 0.68, the calcification was 0.71, and the final diagnosis was good (魏 0.70). Conclusion the evaluation of breast lesions obtained by ABVS is reproducible, but the echo around the lesions and coronal section is of moderate consistency.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2012
【分类号】：R816.4

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