BI-RADS分類聯(lián)合超聲彈性成像在乳腺癌早期篩查的應(yīng)用研究
發(fā)布時間：2018-08-08 18:13
【摘要】：目的:分析BI-RADS(Breast imaging reporting and data system)分類聯(lián)合超聲彈性成像在乳腺實性結(jié)節(jié)鑒別診斷中的價值,并探究在女性乳腺癌早期篩查的應(yīng)用及效果,為今后開展女性乳腺健康教育、制定乳腺癌早期篩查計劃提供科學(xué)依據(jù)。方法:選取我院超聲科在2015年1月-2016年10月因觸診可及乳腺腫塊來我院行乳腺超聲檢查的131例乳腺結(jié)節(jié)患者為研究對象,除外典型的囊性腫物及以囊性為主的混合性腫物,均經(jīng)手術(shù)切除并行組織病理學(xué)檢查。年齡15歲--83歲,平均年齡為45.3±10.5歲。使用儀器為HITACHI二郎神超聲診斷儀,使用6--13MHz的高頻線陣探頭。先進行常規(guī)超聲檢查,再應(yīng)用超聲彈性成像(UE,Ultrasonic Elastography)技術(shù)進行評分及進行應(yīng)變率比值(SR,Strain Ratio)的測量。數(shù)據(jù)應(yīng)用SPSS19.0軟件進行統(tǒng)計分析。計算各方法的準確度、靈敏度、特異度、陽性預(yù)測值、陰性預(yù)測值。各種方法均采用卡方檢驗觀察組間差異是否有統(tǒng)計學(xué)意義。結(jié)果:以下結(jié)果均以手術(shù)后組織病理學(xué)診斷結(jié)果作為金標準進行對照1.常規(guī)超聲BI-RADS分類評價實性結(jié)節(jié)良惡性的準確度、靈敏度、特異度、陽性預(yù)測值、陰性預(yù)測值分別為89.31%、80.56%、92.63%、80.56%、92.63%。2.超聲彈性成像評分以4分及5分為惡性來評價實性結(jié)節(jié)良惡性的準確度、靈敏度、特異度、陽性預(yù)測值、陰性預(yù)測值分別為83.97%、75.00%、87.37%、69.23%、90.22%。3.確定3.12為應(yīng)變率比值良惡性的最佳診斷界限值,以≥3.12為惡性評價,3.12為良性評價,其對實性結(jié)節(jié)良惡性評價的準確度、靈敏度及特異度、陽性預(yù)測值、陰性預(yù)測值分別為84.73%、80.56%、86.31%、69.05%、92.13%。4.常規(guī)超聲BI-RADS分類結(jié)合彈性成像評分對乳腺實性結(jié)節(jié)良惡性診斷的準確度、靈敏度、特異度、陽性預(yù)測值、陰性預(yù)測值分別為87.02%、97.22%、83.16%、68.62%、98.75%。5.四種超聲方法診斷乳腺實性結(jié)節(jié)的準確度、靈敏度、特異度兩兩比較,靈敏度常規(guī)超聲結(jié)合彈性評分較其他每種方法均高,且差異有統(tǒng)計學(xué)意義(P0.05)。特異度常規(guī)超聲較常規(guī)超聲結(jié)合彈性評分高,且差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1.常規(guī)超聲、超聲彈性成像評分、超聲彈性成像應(yīng)變率比值、常規(guī)超聲結(jié)合彈性成像評分對乳腺實性結(jié)節(jié)良惡性的鑒別均有一定的診斷價值,但單純應(yīng)用超聲彈性技術(shù)對乳腺實性結(jié)節(jié)良惡性的鑒別診斷與常規(guī)超聲差異無統(tǒng)計學(xué)意義。2.常規(guī)超聲BI-RADS分類聯(lián)合彈性成像評分或者聯(lián)合超聲彈性成像應(yīng)變率比值診斷方法提高了乳腺癌的早期檢出率,為乳腺癌的早發(fā)現(xiàn)、早診斷、早治療提供了有意義的參考價值。建議采用聯(lián)合診斷方法,有助于提高乳腺疾病早期診斷率,減少誤診率。
[Abstract]:Objective: to analyze the value of BI-RADS (Breast imaging reporting and data system) classification combined with ultrasound elastography in the differential diagnosis of breast solid nodules, and to explore the application and effect of early screening for female breast cancer, and to provide scientific basis for the future development of female breast health education and the formulation of early screening plan for breast cancer. 131 cases of breast nodules in our hospital in October, January 2015 -2016 years, due to palpation and breast lump and breast ultrasonography in our hospital, were studied. Except for typical cystic mass and cystic mass, all of them were excised and histopathologically examined. The age of 15 years old was 45.3 + 10.5 years old, with a mean age of 45.3 + 10.5. Using the instrument as the HITACHI Erlang Shen ultrasonic diagnostic instrument, the high frequency linear array probe of 6--13MHz is used. The routine ultrasound examination is performed first, then the UE (Ultrasonic Elastography) technique is used to evaluate the ratio of strain rate (SR, Strain Ratio). The data are analyzed by the SPSS19.0 software and the methods are used to calculate the methods. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value. All methods used chi square test to observe whether the differences between the groups were statistically significant. Results: the following results were compared with 1. conventional ultrasound BI-RADS to evaluate the accuracy of benign and malignant nodules. The sensitivity, specificity, positive predictive value, negative predictive value were 89.31%, 80.56%, 92.63%, 80.56%, and 92.63%.2. ultrasound elastography score was 4 and 5 as malignant to evaluate the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 83.97%, 75%, 87.37%, 69.23%, 90.22%.3. to determine 3.12 should be determined. The best diagnostic threshold value of the ratio of variable ratio, benign and malignant, was more than 3.12, and 3.12 was benign. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 84.73%, 80.56%, 86.31%, 69.05%, 92.13%.4., respectively, to the mammary gland. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the benign and malignant diagnosis of sexual nodules were 87.02%, 97.22%, 83.16%, 68.62%, and 98.75%.5., respectively, for the accuracy, sensitivity, and specificity 22 of four kinds of ultrasound methods in the diagnosis of breast solid nodules, and the sensitivity of regular ultrasound combined with elastic score was higher than that of the other methods, and the difference was different. There was a statistical significance (P0.05). The specificity of conventional ultrasound was higher than that of conventional ultrasound, and the difference was statistically significant (P0.05). Conclusion: 1. conventional ultrasound, ultrasound elastography score, ultrasonic elastography strain rate ratio, and conventional ultrasound combined with elastography have a certain diagnostic value for the differential diagnosis of benign and malignant breast nodules. There is no significant difference between the differential diagnosis of benign and malignant breast tubercle with Ultrasonic Elastic technique, but there is no significant difference between conventional ultrasound and conventional ultrasound.2. BI-RADS classification combined with elastic imaging score or combined ultrasonic elastic imaging strain rate ratio diagnosis method to improve the early detection rate of breast cancer, early detection and early diagnosis of breast cancer It is suggested that the combined diagnosis method should be used to improve the early diagnosis rate of breast diseases and reduce the misdiagnosis rate.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.1;R737.9
本文編號：2172609
[Abstract]:Objective: to analyze the value of BI-RADS (Breast imaging reporting and data system) classification combined with ultrasound elastography in the differential diagnosis of breast solid nodules, and to explore the application and effect of early screening for female breast cancer, and to provide scientific basis for the future development of female breast health education and the formulation of early screening plan for breast cancer. 131 cases of breast nodules in our hospital in October, January 2015 -2016 years, due to palpation and breast lump and breast ultrasonography in our hospital, were studied. Except for typical cystic mass and cystic mass, all of them were excised and histopathologically examined. The age of 15 years old was 45.3 + 10.5 years old, with a mean age of 45.3 + 10.5. Using the instrument as the HITACHI Erlang Shen ultrasonic diagnostic instrument, the high frequency linear array probe of 6--13MHz is used. The routine ultrasound examination is performed first, then the UE (Ultrasonic Elastography) technique is used to evaluate the ratio of strain rate (SR, Strain Ratio). The data are analyzed by the SPSS19.0 software and the methods are used to calculate the methods. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value. All methods used chi square test to observe whether the differences between the groups were statistically significant. Results: the following results were compared with 1. conventional ultrasound BI-RADS to evaluate the accuracy of benign and malignant nodules. The sensitivity, specificity, positive predictive value, negative predictive value were 89.31%, 80.56%, 92.63%, 80.56%, and 92.63%.2. ultrasound elastography score was 4 and 5 as malignant to evaluate the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 83.97%, 75%, 87.37%, 69.23%, 90.22%.3. to determine 3.12 should be determined. The best diagnostic threshold value of the ratio of variable ratio, benign and malignant, was more than 3.12, and 3.12 was benign. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 84.73%, 80.56%, 86.31%, 69.05%, 92.13%.4., respectively, to the mammary gland. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the benign and malignant diagnosis of sexual nodules were 87.02%, 97.22%, 83.16%, 68.62%, and 98.75%.5., respectively, for the accuracy, sensitivity, and specificity 22 of four kinds of ultrasound methods in the diagnosis of breast solid nodules, and the sensitivity of regular ultrasound combined with elastic score was higher than that of the other methods, and the difference was different. There was a statistical significance (P0.05). The specificity of conventional ultrasound was higher than that of conventional ultrasound, and the difference was statistically significant (P0.05). Conclusion: 1. conventional ultrasound, ultrasound elastography score, ultrasonic elastography strain rate ratio, and conventional ultrasound combined with elastography have a certain diagnostic value for the differential diagnosis of benign and malignant breast nodules. There is no significant difference between the differential diagnosis of benign and malignant breast tubercle with Ultrasonic Elastic technique, but there is no significant difference between conventional ultrasound and conventional ultrasound.2. BI-RADS classification combined with elastic imaging score or combined ultrasonic elastic imaging strain rate ratio diagnosis method to improve the early detection rate of breast cancer, early detection and early diagnosis of breast cancer It is suggested that the combined diagnosis method should be used to improve the early diagnosis rate of breast diseases and reduce the misdiagnosis rate.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.1;R737.9
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