自动乳腺全容积成像技术诊断乳腺肿物的临床应用价值

发布时间：2018-02-02 03:33

本文关键词： 超声检查钼靶乳腺肿物自动乳腺全容积成像技术　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对比研究常规超声检查、自动乳腺全容积成像技术(ABVS)及钼靶(MG)检查对乳腺肿物的诊断结果,评价ABVS对乳腺肿物的诊断价值。方法:选取2016年5月至12月在我院就诊的120例女性患者,共156枚乳腺肿物,所有病例均取得穿刺及术后病理结果。先用常规超声对双侧乳腺进行扫查,记录病灶的大小、形态、边界、内部回声、有无钙化,是否有后方衰减,并依据BI-RADS评估指标进行评级,再用ABVS系统对双侧乳腺进行全容积扫查,并对传输至工作站的图片进行分析,依据BI-RADS评估指标进行评级,结合MG对乳腺肿物检查的诊断结果,以病理结果为金标准,采用χ2检验,比较常规超声、ABVS和MG三种检查的诊断效能,P0.05差异有统计学意义;Z检验比较常规超声、ABVS及MG的ROC曲线下面积;采用Kappa值就ABVS和MG对乳腺钙化检出一致性进行评价。探讨ABVS诊断乳腺肿物的临床应用价值。结果:(1)入选的120位女性患者,年龄23~78岁,平均(47.66±12.38)岁,良性病灶患者年龄为(40.75±11.14)岁,恶性病灶患者年龄为(52.77±11.42)岁,差异有统计学意义(t=5.977,P0.05);(2)肿瘤直径0.4~6.1cm,平均(1.78±1.03)cm,良性病灶患者肿块大小为(1.79±1.16)cm,恶性病灶患者肿块大小为(1.76±0.90)cm,差异无统计学意义(P=0.873);(3)常规超声诊断恶性肿瘤66例,病理证实83例(79%);诊断良性肿瘤53例,病理证实73例(72%)。常规超声诊断乳腺肿物灵敏度为75.7%、特异度为76.0%、准确度为75.8%。ABVS诊断恶性肿瘤81例,经病理证实83例(97%);诊断良性肿瘤64例,经病理证实73例(87%)。ABVS诊断乳腺肿物灵敏度为97.6%、特异度为87.7%、准确度为92.9%。MG诊断恶性肿瘤67例,经病理证实83例(80%);诊断良性肿瘤54例,经病理证实73例(73%)。MG诊断乳腺肿物灵敏度为80.7%、特异度为74.0%、准确度为77.6%。常规超声与MG诊断乳腺肿物的灵敏度、特异度、准确度差异均无统计学意义(P0.05)。ABVS诊断乳腺肿物的灵敏度、特异度、准确度均高于常规超声,差异均有统计学意义(χ2=11.65、4.30、15.39,P0.05)。ABVS诊断乳腺肿物的灵敏度、准确度均高于MG检查,差异均有统计学意义(χ2=10.53、13.49,P0.05);两者特异度比较差异无统计学意义(χ2=3.58,P=0.06)。(4)常规超声、ABVS及MG的ROC曲线下面积分别为0.759、0.936、0.763;(5)汇聚现象诊断乳腺肿物灵敏度为44.9%、特异度为100%、准确度为68.3%;(6)ABVS与MG对乳腺钙化的诊断结果一致性较好(Kappa值=0.79,P0.05)。结论:ABVS独特的三维成像技术,乳腺的自动全容积扫查,特有的冠状面能够清晰的显示病灶,使病灶图像更直观,逼真,以提高检查者诊断乳腺癌的准确率;MG和ABVS两种检查方法对钙化的检出一致性好,ABVS有效的弥补了常规超声在诊断钙化方面的不足,有助于提高病变良恶性的诊断。相比常规超声、MG对乳腺肿物诊断的灵敏度、准确度更高,具有重要的临床诊断价值。
[Abstract]:Objective: to study the diagnostic results of breast mass by conventional ultrasound, automatic full volume mammography (ABVS) and mammography (MG). To evaluate the value of ABVS in the diagnosis of breast masses. Methods: a total of 156 breast masses were selected from 120 female patients who were admitted to our hospital from May 2016 to December. The results of puncture and postoperative pathology were obtained in all cases. The bilateral mammary glands were scanned with conventional ultrasound to record the size, shape, boundary, internal echo, calcification and posterior attenuation of the lesions. According to the evaluation index of BI-RADS, the whole volume of bilateral mammary gland was scanned by ABVS system, and the images transmitted to workstation were analyzed. The image was rated according to the evaluation index of BI-RADS, and combined with the diagnostic result of MG for mammary gland mass examination. According to the pathological results as gold standard, 蠂 2 test was used to compare the diagnostic efficacy of conventional ultrasonography with ABVS and MG (P0.05). There was significant difference between Z test and conventional ultrasound under the ROC curve of ABVS and MG. Kappa value was used to evaluate the consistency of ABVS and MG in the detection of breast calcification. To explore the clinical application value of ABVS in the diagnosis of breast tumor. Results the age of 120 female patients with benign lesions was 47.66 卤12.38 years old, and the age of benign lesions patients was 40.75 卤11.14 years, the age of 120 female patients was 237.66 卤12.38 years old, the age of the patients with benign lesions was 40.75 卤11.14 years. The age of the patients with malignant lesions was 52.77 卤11.42 years old. The difference was statistically significant (P < 0.05). The diameter of malignant lesions was 0.4 ~ 6.1cm (mean 1.78 卤1.03cm), the size of benign lesions was 1.79 卤1.16cm, and the size of malignant lesions was 1.76 卤0.90cm. There was no significant difference between the two groups. 83 cases were proved by pathology, 53 cases were benign tumors, and 73 cases were confirmed by pathology. The sensitivity, specificity, accuracy, accuracy and pathology of conventional ultrasound in the diagnosis of breast masses were 75.75.7, 76.0, 75.8.ABVS, 83.83, respectively, and 64 cases of benign tumors were diagnosed. The sensitivity, specificity, accuracy, accuracy, pathology and pathology of 73 cases were 97.6, 87.7, 92.9.MG, 83 cases, 54 cases, respectively. The sensitivity, specificity and accuracy of routine ultrasound and MG in the diagnosis of breast masses were 80.7, 74.0 and 77.6.The sensitivity, specificity and accuracy of routine ultrasound and MG in the diagnosis of breast masses were not statistically significant. The specificity and accuracy were higher than those of conventional ultrasound, and the difference was statistically significant (蠂 ~ 2 11.65 ~ 4.30 ~ 15.39 ~ 15.39% P0.05U. ABVS) in the diagnosis of breast tumor. The accuracy of ABVS was higher than that of MG. The difference was statistically significant (蠂 ~ 2 / 10.53 ~ 13.49 / P 0.05), and there was no significant difference in specificity between the two groups (蠂 ~ (2) ~ (3.58)). The areas under the ROC curve of conventional ultrasound and MG were 0.759 ~ 0.93ng / 60.7635). The sensitivity, specificity, accuracy and accuracy of conventional ultrasound ABVS and MG in the diagnosis of breast masses were 44.9, 100 and 68.33A, respectively, and the area under the ROC curve was 0.759 and 0.930.7635 respectively. The diagnostic sensitivity was 44.9, the specificity was 100, and the accuracy was 68.33%. The diagnostic results of MG for breast calcification are in good agreement with the Kappa value of 0.79 and P0.05.Conclusion the special three-dimensional imaging technique of the 30% ABVS may be useful in the diagnosis of breast calcification. Automatic full volume scanning of mammary gland, unique coronal plane can clearly display the focus, making the focus image more intuitive and realistic, In order to improve the diagnostic accuracy of breast cancer in examiners, MG and ABVS can effectively compensate for the deficiency of conventional ultrasound in the diagnosis of calcification. It is helpful to improve the diagnosis of benign and malignant lesions. Compared with the conventional ultrasound MG, the sensitivity of the diagnosis of breast masses is higher and the accuracy is higher, which has important clinical value.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R737.9

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