本文選題：乳腺良性結節(jié) + 超聲彈性成像��； 參考：《大連醫(yī)科大學》2017年碩士論文

【摘要】：乳腺纖維瘤等良性結節(jié)是女性常見乳腺疾病。超聲引導下射頻消融術是臨床醫(yī)生治療此類疾病的主要方法之一。本研究運用超聲E成像技術評估乳腺良性結節(jié)射頻術后消融灶的吸收情況,并分析多種不同因素對消融灶吸收情況的影響,以期為臨床提供更多治療新信息。研究目的1.探討超聲引導下射頻消融對治療乳腺良性結節(jié)的有效性。2.探討超聲E成像評估乳腺良性結節(jié)射頻術后消融灶吸收效果的的可行性。3.探討不同臨床因素與乳腺良性結節(jié)射頻術后消融灶吸收情況的相關性。研究方法收集自2015年9月份起入我院三部超聲科進行乳腺射頻消融的38例患者,共99枚良性結節(jié)。根據乳腺生理分期,患者處于性成熟期(18～45歲)的結節(jié)62枚,處于更年期(45～52歲)結節(jié)24枚,處于絕經期(52歲以后)患者13枚。根據結節(jié)所在象限位置,位于外上象限的結節(jié)24枚,位于外下象限的結節(jié)19枚,位于內上象限的結節(jié)38枚,位于內下象限的結節(jié)18枚。根據結節(jié)大小,結節(jié)長徑1cm 40枚,1cm結節(jié)長徑3cm 59枚。分別對每個結節(jié)進行術前及術后每月一次的隨訪觀察,為期12個月。在常規(guī)超聲模式下,測量記錄所有消融灶每個月的體積,并計算所有消融灶每個月的體積減小率(與術前相比);在超聲E成像模式下測量記錄所有消融灶每個月的彈性Ratio比值。分別比較:①術前及術后每個月所有消融灶體積大小和術后消融灶體積減小率的變化。② 術前及術后每個月所有消融灶彈性Ratio比值的變化,以及彈性Ratio比值變化與消融灶體積變化之間的相關性。③每個月消融灶體積減小率與結節(jié)大小、乳腺生理分期、象限之間的相關性。采用SPSS 17.0分析軟件,數值以(均數±標準差)表示,運用重復測量方差分析、Pearson相關性分析及回歸分析和獨立樣本t檢驗等統(tǒng)計學方法進行統(tǒng)計學分析。研究結果:1、術前與術后每個月所有消融灶體積之間的變化、消融灶體積減小率之間的變化比較差異有統(tǒng)計學意義(P0.05)。2、術前及術后每個月所有消融灶彈性Ratio比值之間的變化比較差異有統(tǒng)計學意義(P0.05)。彈性Ratio比值的變化與術后消融灶體積的變化存在相關性(P0.05)。3、每個月所有消融灶體積減小率與結節(jié)大小之間存在相關性(P0.05),與乳腺生理分期和乳腺象限位置之間并無相關性(P0.05)。結節(jié)長徑1cm與1cm結節(jié)長徑3cm的結節(jié)之間,比較術后消融灶體積減小率差異有統(tǒng)計學意義(P0.05)。4、術后8月后消融灶體積、消融灶體積減小率(與術前相比)及彈性Ratio比值的變化明顯減小。結論:1、超聲引導下射頻消融術對乳腺良性結節(jié)的治療具有有效性。2、超聲彈性成像可作為評價乳腺良性結節(jié)射頻術后消融灶吸收情況的可行性手段。超聲彈性成像證明隨著隨訪時間的延長,彈性Ratio比值先升高,后逐漸降低。3、結節(jié)大小是超聲引導下乳腺良性結節(jié)射頻術后消融灶吸收效果的影響因素,結節(jié)大者吸收較快。4、術后第8個月可以作為評價超聲引導下乳腺良性結節(jié)射頻術后吸收效果的一個關鍵月份。
[Abstract]:Benign nodules, such as mammary fibroma, are common breast diseases. Ultrasound guided radiofrequency ablation is one of the main methods for clinicians to treat such diseases. Ultrasound E imaging is used to assess the absorption of ablation foci after radiofrequency surgery for benign breast nodules and to analyze the effects of various factors on the absorption of the ablation foci. To provide more new information for clinical treatment. Objective 1. to explore the effectiveness of ultrasound guided radiofrequency ablation for the treatment of benign breast nodules: a study of the feasibility of ultrasonic E imaging in assessing the effect of radiofrequency ablation for benign breast nodules after radiofrequency ablation.3. to explore different clinical factors and absorption after radiofrequency ablation for benign breast nodules after radiofrequency operation..3. A total of 99 benign nodules were collected from 38 cases of breast radiofrequency ablation in three ultrasound departments of our hospital from September 2015. According to the physiological stages of the breast, 62 nodules were in the sexual maturity (18~45 years old), 24 in menopause (45~52 years old), 13 in the menopause (after 52 years of age). According to the quadrant position of the nodule, 24 nodules located outside the upper quadrant, 19 nodules located in the outer quadrant, 38 nodules in the upper quadrant, 18 in the inner and lower quadrant, 40 and 3cm 59, according to the size of the nodules, and the long diameter of 1cm nodules, respectively, for each nodule before and after a monthly follow-up observation, respectively, The volume of all ablation foci per month was recorded and the volume reduction rate of all ablation foci was calculated (compared with preoperative) under the conventional ultrasound mode. The elastic Ratio ratio of all ablation foci was recorded in the ultrasonic E imaging mode. The volume of all ablation foci was larger than that before and after the operation. Changes in the elastic Ratio ratio of all ablation foci before and after operation, and the correlation between the changes of the elastic Ratio ratio and the volume change of the ablation focus. (3) the correlation between the volume reduction rate of the ablation focus and the size of nodules, the physiological stages of the breast and the quadrant of the mammary gland each month. Using SPSS 17 The analysis software was used to perform statistical analysis with repeated measurements of variance analysis, Pearson correlation analysis and regression analysis and independent sample t test. The results were as follows: 1, the changes in the volume of all ablation foci before and after the operation, and the comparison of the volume reduction rate between the ablation foci before and after the operation. The difference was statistically significant (P0.05).2. There was a significant difference between the elastic Ratio ratio of all ablation foci before and after the operation (P0.05). There was a correlation between the changes of the ratio of elastic Ratio and the change of the volume of the ablation focus (P0.05).3, and there was a correlation between the reduction rate of the ablation range and the size of the nodules each month. There was no correlation between sex (P0.05) and breast physiological staging and breast quadrant position (P0.05). Between nodular length diameter 1cm and 1cm nodule long diameter 3cm nodules, there was a statistically significant difference (P0.05).4, the volume of ablation foci after August, the reduction rate of ablation foci (compared with preoperative) and the ratio of elastic Ratio. Conclusions: 1. Ultrasound guided radiofrequency ablation is effective in the treatment of benign breast nodules. Ultrasound elastography can be used as a feasible means to evaluate the absorption of benign breast nodules after radiofrequency ablation. Elastography shows that the ratio of elastic Ratio increases first and then gradually increases with the duration of follow-up. To reduce.3, the size of nodules is an influential factor in the absorption of radiofrequency ablation for benign breast nodules under ultrasound guidance. The large nodule absorbs fast.4, and eighth months after operation can be used as a key month to evaluate the absorption effect of ultrasonic guided breast benign nodules after radiofrequency operation.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R445.1;R655.8
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本文編號：1995174