乳腺X线摄影和超声检查诊断乳腺癌的对比研究

发布时间：2018-06-14 20:01

本文选题：乳腺癌 + 钼靶　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]拟探讨钼靶X线摄影和超声应用于乳腺癌诊断的意义与差别,以提高乳腺癌的临床检出率,为优化影像学检查策略提供可靠依据。[方法]回顾性分析2015年12月至2016年12月在昆明市第一人民医院乳腺中心就诊病例中,经术前影像学检查,术后病理报告证实的355名乳腺癌患者。对该355份病历进行回顾性分析,355名患者均行超声及钼靶检查,随机分为三组,单独统计超声结果的有125例病人,单独统计钼靶结果的有103例病人,统计组合检测结果的有127例患者。以病理结果为金标准,采用卡方检验分析比较钼靶、超声、钼靶联合超声三种检查方法对于诊断乳腺癌的检出率、漏诊率的差异;根据患者年龄、腺体类型、影像学表现等着重分析超声与钼靶X线摄影对于乳腺癌诊断的价值对比。[结果]1.两种检查组合和单一超声和单一钼靶X线检查相比,检出率和漏诊率有统计学差别。钼靶X线检查和超声就检出率和漏诊率对比无统计学差异。2.超声对于肿块、异常血流和腋窝淋巴结检出率高于乳房X线检查,而乳房X线对微钙化检出率高,对于肿块形状是否规则,边界是否清晰两者无统计学差异。3.钼靶X线在脂肪型及少量腺体型乳房中对乳腺癌的检出率高于超声,而超声对于多量腺体型及致密型乳房乳腺癌检查率明显高于钼靶X线,差别具有统计学意义。4.根据年龄分组,超声与钼靶在26-39岁年龄组与50-59、60-69岁年龄组间差异具有统计学意义。[结论]钼靶X线检查和超声分别有各自优势。组合应用可以使两个检查优势互补,显著提高了检出率,降低乳腺癌漏诊率。最终,最佳乳腺癌症检查策略需要个性化的方法,根据患者个体异质性如年龄,风险和乳房密度等指标选择性应用检查技术。
[Abstract]:[objective] to explore the significance and difference of mammography and ultrasound in the diagnosis of breast cancer, in order to improve the clinical detection rate of breast cancer and to provide reliable basis for optimizing the imaging examination strategy. [methods] from December 2015 to December 2016, 355 patients with breast cancer confirmed by preoperative imaging examination and pathological report were retrospectively analyzed in the breast center of the first people's Hospital of Kunming City. A retrospective analysis of 355 cases was carried out. All 355 patients were examined by ultrasound and molybdenum target. The patients were randomly divided into three groups: 125 patients with single ultrasound results and 103 patients with molybdenum target results. There were 127 patients with combined results. The diagnostic rate and missed rate of breast cancer were compared by chi-square test and chi-square test according to the age of the patients, the type of glands, and the difference of the detection rate and the missed rate of breast cancer by three methods: mammography, ultrasound and mammography. Imaging findings were focused on the value of ultrasound and mammography in the diagnosis of breast cancer. [result] 1. Compared with single ultrasound and single molybdenum target X-ray examination, the detection rate and missed diagnosis rate were significantly different between the two examination combinations. There was no significant difference in detection rate and missed diagnosis rate between mammography and ultrasound. The detection rate of abnormal blood flow and axillary lymph nodes in ultrasound was higher than that in mammography, but the detection rate of microcalcification in mammography was higher than that in mammography. The detection rate of mammography for breast cancer in fat type and a few glandular type was higher than that in ultrasound, but the detection rate of ultrasound for breast cancer of multiple glandular type and dense type was significantly higher than that of mammography, the difference was statistically significant. According to the age group, the difference between ultrasound and molybdenum target was statistically significant between the age group of 26-39 years and the age group of 50-990-69 years old. [conclusion] Molybdenum target X-ray examination and ultrasound have their respective advantages. The combined application can make the two examinations complement each other, improve the detection rate and reduce the missed diagnosis rate of breast cancer. Finally, the best breast cancer screening strategy requires a personalized approach, which is selectively applied according to the patient's individual heterogeneity such as age, risk and breast density.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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