声脉冲辐射力成像对乳腺病灶BI-RADS分级的应用价值

发布时间：2018-02-03 02:07

  本文关键词： 弹性成像技术 乳腺疾病 超声检查 平均光密度 BI-RADS分级　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的应用声脉冲辐射力成像(ARFI)技术观察乳腺病灶组织软硬度,定量分析声脉冲辐射力成像技术对乳腺影像报告和数据系统(BI-RADS)的价值,期待早期发现乳腺恶性病灶患者,提高患者的生存率及生活质量。资料与方法收集经穿刺细胞学检查及手术病理结果确诊的175例患者共179个乳腺病灶,均进行常规超声、声触诊组织量化(VTQ)检查、声触诊组织成像(VTI)检查,得出病灶的剪切波速度值(SWV)及通过使用Image J软件分析VTI图像计算得出的平均光密度值,并将乳腺病灶的常规超声图像进行BI-RADS分级。通过统计方法比较常规超声BI-RADS分级、VTQ检查、VTI检查及三者联合方法在乳腺病灶诊断中的差异,分析声脉冲辐射力成像在BI-RADS分级中的意义。结果1.经过病理证实,179个乳腺病灶中恶性病灶71个、良性病灶108个。绘制ROC曲线,VTQ检查得出剪切波速度值的ROC曲线下面积(AUC)为0.883,分析得出判断良恶性乳腺病灶的界值为3.54m/s;VTI检查得出平均光密度值的曲线下面积为0.933,所对应的界值为202.25。恶性乳腺病灶VTQ值≥3.54m/s个数为55,3.54 m/s个数为16,良性乳腺病灶VTQ值≥3.54 m/s个数为7,3.54m/s个数为101(t=11.227,P=0.000)。恶性乳腺病灶的平均光密度值≥202.25的个数为66,202.25的个数为5,良性乳腺病灶的平均光密度值≥202.25的个数为10,202.25的个数为98(t=12.364,P=0.000)。常规超声BI-RADS分级在诊断乳腺良恶性病灶的敏感度97.18%(69/71)、特异度42.59%(46/108)、阳性预测值52.67%(69/131)、阴性预测值95.83%(46/48)、准确率64.25%(115/179),约登指数0.3977;三者联合方法在诊断乳腺病灶的敏感度94.37%(67/71)、特异度88.89%(96/108)、阳性预测值84.81%(67/79)、阴性预测值96%(96/100)、准确率91.06%(163/179)及约登指数0.8326。2.VTQ检查与常规超声BI-RADS分级比较:常规超声BI-RADS分级灵敏度高于VTQ检查(P=0.001),VTQ检查特异度、阳性预测值、准确率高于常规超声BI-RADS分级(P=0.000),以特异度指标更好。3.VTQ检查与三者联合方法比较:联合方法灵敏度高于VTQ检查(P=0.004)。4.VTI检查与常规超声BI-RADS分级比较:VTI检查特异度、阳性预测值、准确率高于常规超声BI-RADS分级(P=0.000),以特异度指标更好。5.三者联合方法与常规超声BI-RADS分级比较:联合方法特异度、阳性预测值、准确率高于常规超声BI-RADS分级(P=0.000),以特异度指标更好。结论1.声脉冲辐射力成像的两种方法VTQ检查与VTI检查在诊断乳腺良恶性病灶中具有重要意义。2.VTQ检查与VTI检查比较,在诊断乳腺良恶性病灶上各参数指标无明显差异。3.声脉冲辐射力成像能弥补常规超声的不足,早期发现恶性小病灶,较准确判断乳腺良恶性病灶,提高了诊断准确率。
[Abstract]:Objective to observe the soft and hard degree of breast lesions by acoustic pulse radiation force imaging (ARFI). Quantitative analysis of the value of acoustic pulse radiography in breast imaging reporting and data system BI-RADS, looking forward to early detection of breast malignant lesions in patients. Data and methods 175 patients with 179 breast lesions confirmed by puncture cytology and surgical and pathological results were examined by conventional ultrasound. Acoustic palpation tissue quantification (VTQ) and acoustic palpation tissue imaging (VTI) were examined. The shear wave velocity (SWV) of the lesion was obtained and the average optical density was calculated by using Image J software to analyze the VTI images. The conventional ultrasound images of breast lesions were graded by BI-RADS. The conventional ultrasound BI-RADS grading was compared with VTQ by statistical method. The difference of VTI examination and combination of three methods in the diagnosis of breast lesions was analyzed. The significance of acoustic pulse radiography in BI-RADS grading was analyzed. Results 1.The results were confirmed by pathology. There were 71 malignant lesions and 108 benign lesions in 179 breast lesions. The area under the ROC curve of ROC curve was 0.883. The results showed that the cutoff value of benign and malignant breast lesions was 3.54 m / s; VTI showed that the area under the average optical density curve was 0.933, and the corresponding threshold value was 202.25.The number of VTQ 鈮，

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