本文選題：乳腺腫塊　切入點(diǎn)：常規(guī)超聲　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討剪切波彈性成像技術(shù)(SWE)與BI-RADS分類結(jié)合鑒別乳腺良惡性病變的價(jià)值。方法:對(duì)87例患者中最終獲取病理結(jié)果的121個(gè)乳腺腫塊作為研究對(duì)象,其中包括男性2例(各1個(gè)病灶),女性85例(119個(gè)病灶)。術(shù)前對(duì)患者均行常規(guī)超聲檢查,觀察及二維圖像特征并對(duì)其進(jìn)行BI-RADS分類,然后對(duì)病灶進(jìn)行SWE檢查,測(cè)量腫塊內(nèi)部組織和腫塊周邊組織的各個(gè)彈性模量參數(shù)SD、Emax、Eratio、Emean、Emin,同時(shí)觀察并且記錄病灶的彩色彈性模式分類,并計(jì)算出各個(gè)彈性模量參數(shù)的診斷最佳閾值。結(jié)果:(1)病理結(jié)果為乳腺病灶良性89個(gè),惡性32個(gè),常規(guī)超聲下腫塊在其形態(tài)和方位、邊緣和內(nèi)部及后方的回聲特點(diǎn)、鈣化和腫塊內(nèi)部及周邊血流信號(hào)方面差異均具有統(tǒng)計(jì)學(xué)意義。(2)SWE下乳腺惡性腫塊內(nèi)部及周邊組織的彈性模量參數(shù)SD、Emean、Emax、Eratio大于良性腫塊(P0.001)。腫塊內(nèi)部及周邊組織的彈性模量參數(shù)Emax有最佳的ROC曲線下面積,分別為0.911、0.941,其診斷閾值分別取78.7Kpa和84.2Kpa時(shí),診斷性能最佳。(3)SWE下乳腺惡性病灶的大小大于常規(guī)超聲,并且與常規(guī)超聲相比更接近組織學(xué)大小。彩色彈性模式分類的最佳診斷界點(diǎn)為模式2、3。(4)常規(guī)超聲BI-RADS分類聯(lián)合腫塊周邊組織Emax及SWE彩色彈性模式診斷性能最佳,敏感度為97.8%,特異度為88.7%,診斷性能相比BI-RADS分類增加,診斷特異性升高。結(jié)論:SWE彈性模量參數(shù)及彩色彈性模式分類可以為評(píng)價(jià)乳腺腫塊的良惡性補(bǔ)充新的診斷參數(shù),其中腫塊周邊組織的彈性模量參數(shù)Emax及腫塊的彩色彈性模式與常規(guī)超聲BI-RADS分類結(jié)合診斷性能最佳,提供了新的診斷依據(jù)。
[Abstract]:Objective: to evaluate the value of combining shear wave elastography with BI-RADS classification in differentiating benign and malignant breast lesions. Methods: 121 breast masses with final pathological results were studied in 87 patients. There were 2 males (1 focus each) and 85 females (119 lesions). All the patients were examined by conventional ultrasound before operation, the features of two-dimensional images were observed and classified by BI-RADS, then the lesions were examined by SWE. The elastic modulus parameters of the inner tissue of the tumor and the surrounding tissue of the tumor were measured, and the color elastic model classification of the lesions was observed and recorded. The optimal diagnostic threshold of each elastic modulus parameter was calculated. Results the pathological results were 89 benign and 32 malignant breast lesions. The shape and orientation of the masses, the echo characteristics of the edges and the interior and the rear of the masses under conventional ultrasound were obtained. There were significant differences in calcification and blood flow signal in and around the tumor. Under SWE, the elastic modulus parameters of breast malignant mass were higher than that of benign tumor (P 0.001). The elastic modulus of the inner and peripheral tissues of the tumor was higher than that of the benign tumor. The elastic modulus of the inner and peripheral tissues of the malignant breast tumor was higher than that of the benign tumor. The parameter Emax has the best area under the ROC curve, When the diagnostic threshold was taken from 78.7Kpa and 84.2Kpa, the size of malignant breast lesions under the best diagnostic performance was larger than that of conventional ultrasound. Compared with conventional ultrasound, it is closer to histological size. The best diagnostic threshold for color elastic mode classification is mode 2 / 3. 4) conventional BI-RADS combined with Emax and SWE color elastic mode has the best diagnostic performance. The sensitivity is 97.8 and the specificity is 88.7. Compared with BI-RADS classification, the diagnostic performance is higher and the diagnostic specificity is higher. Conclusion the elastic modulus parameter and color elastic model classification can be used to evaluate benign and malignant breast masses with new diagnostic parameters. The diagnostic performance of Emax and color elastic model combined with conventional ultrasonic BI-RADS classification is the best, which provides a new diagnostic basis.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.1;R737.9

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