本文選題：乳腺結(jié)構(gòu)扭曲　切入點(diǎn)：乳腺X線檢查　出處：《寧夏醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的1、分析乳腺X線及MRI檢查對結(jié)構(gòu)扭曲病變的影像學(xué)診斷價(jià)值;2、探討乳腺X線及MRI兩種檢查方法臨床診斷價(jià)值。材料與方法根據(jù)乳腺BI-RADS分類標(biāo)準(zhǔn)第四版,收集在我院行乳腺X線檢查并診斷結(jié)果為單純結(jié)構(gòu)扭曲病灶的女性患者共49例,同時(shí)排除病灶影像學(xué)表現(xiàn)合并腫塊、鈣化等典型惡性征象病例,所有病例均未經(jīng)任何手術(shù)、穿刺活檢等治療前行乳腺M(fèi)RI檢查�；仡櫺苑治�49例具備完整病理診斷結(jié)果患者的乳腺X線檢查及乳腺M(fèi)RI檢查影像學(xué)表現(xiàn)。結(jié)果1、在49例乳腺結(jié)構(gòu)扭曲病人中,病理診斷結(jié)果良性15例,惡性34例;2、乳腺X線檢查對結(jié)構(gòu)扭曲病灶的檢出具有發(fā)現(xiàn)價(jià)值,乳腺結(jié)構(gòu)扭曲病灶邊緣特征差異具有統(tǒng)計(jì)學(xué)意義,其中良性結(jié)構(gòu)扭曲邊緣以模糊(53.3%)為主,而惡性病灶以星芒狀(50.0%)較易出現(xiàn),然而病灶最大長徑及象限分布差異均無統(tǒng)計(jì)學(xué)意義(P0.05);3、乳腺DCE-MRI中良惡性結(jié)構(gòu)扭曲病灶強(qiáng)化分布形式、內(nèi)部增強(qiáng)特點(diǎn)有顯著差異,且有統(tǒng)計(jì)學(xué)意義(P0.05),其中良性結(jié)構(gòu)扭曲病灶較易出現(xiàn)區(qū)域樣分布(46.7%)、均勻強(qiáng)化(53.3%),而惡性病變則以段樣分布(35.3%)、簇狀小環(huán)樣強(qiáng)化(44.1%)為主。良性病灶邊緣以光整或不規(guī)則為主,而惡性病灶邊緣以不規(guī)則及毛刺為主,差別有統(tǒng)計(jì)學(xué)意義(P0.05),其敏感度為97.1%,特異度為40%,準(zhǔn)確度為79.6%;4、TIC曲線中良性結(jié)構(gòu)扭曲病變以持續(xù)型(I型)及平臺(tái)型(II型)為主,惡性病灶以廓清型(III型)為主,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);5、在DWI圖像掃描時(shí)取b值取1000s/mm2,良惡性結(jié)構(gòu)扭曲病灶的擴(kuò)散敏感系數(shù)(ADC值)差別具有統(tǒng)計(jì)學(xué)意義(P0.05),采用ADC值=1.22×10-3 mm2/s作為診斷惡性結(jié)構(gòu)扭曲病灶閾值點(diǎn),其敏感度為70.6%,特異度為73.3%,準(zhǔn)確度為71.4%。結(jié)論乳腺X線檢查對結(jié)構(gòu)扭曲病灶更具發(fā)現(xiàn)價(jià)值,其中邊緣形態(tài)特征對診斷良惡性病灶意義較大,但乳腺結(jié)構(gòu)扭曲病變的象限部位及病灶的大小對鑒別良惡性病灶不具有特異價(jià)值;MRI快速成像序列、DCE-MRI及DWI成像對結(jié)構(gòu)扭曲病灶的臨床診斷及鑒別診斷具有重要價(jià)值,其中ADC值更具診斷價(jià)值。
[Abstract]:Objective 1. To analyze the value of mammography and MRI in the imaging diagnosis of structural distortion. (2) to explore the clinical diagnostic value of mammography and MRI. A total of 49 female patients who underwent mammography in our hospital and were diagnosed as simply distorted lesions were included. The imaging findings of the lesions were excluded from typical malignant signs, such as mass, calcification, etc. All cases were not operated on. Mammography and mammary MRI imaging findings of 49 patients with complete pathological diagnosis were retrospectively analyzed. Results 1 among 49 patients with structural distortion of the mammary gland, The results of pathological diagnosis were benign in 15 cases and malignant in 34 cases. Mammography was valuable in the detection of structural distortion lesions, and the difference of the edge features of the lesions was statistically significant. Among them, the distortion margin of benign structure was fuzzy 53.3%, while the malignant lesion was 50.0%. However, there was no significant difference in the distribution of the largest length and quadrant of the lesion, and the enhanced distribution of benign and malignant lesions in breast DCE-MRI was not significant (P 0.05), but there was no significant difference in the distribution of the maximum length and quadrant of the lesion. There are significant differences in the characteristics of internal enhancement, There was significant difference in P0.05, in which 46.7% of the lesions with benign structures were more likely to be localized, and 53.3% of the lesions were evenly enhanced, while the malignant lesions were mainly distributed in the segmental form with 35.3% and 44.1% in clusters). The margin of benign lesions was smooth or irregular. The margin of malignant lesions was mainly irregular and burr, the difference was significant (P 0.05), the sensitivity was 97.1, the specificity was 40, and the accuracy was 79.6%. In the TIC curve, the benign structural distortion lesions were of type I) and the type of platform type II). The major malignant lesions were type III (clearance type). The difference was statistically significant (P < 0.05). The b value was taken at 1000 s / mm ~ (2) and the diffusive sensitivity coefficient of benign and malignant structure distortion lesions was obtained by using ADC value of 1.22 脳 10 ~ (-3) mm2/s as the threshold point for the diagnosis of malignant structure distortion lesions in DWI image scanning, and the diffusion-sensitivity coefficient of benign and malignant structures was 1.22 脳 10 ~ (-3) mm2/s. The sensitivity, specificity and accuracy of mammography were 70.6 and 73.3, respectively. Conclusion mammography is of great value in the diagnosis of benign and malignant lesions, especially in the diagnosis of benign and malignant lesions. However, the quadrant location and the size of the lesions are of no specific value in differentiating benign and malignant lesions. DCE-MRI and DWI imaging are of great value in the clinical diagnosis and differential diagnosis of structurally distorted lesions. The value of ADC is more valuable for diagnosis.
【學(xué)位授予單位】：寧夏醫(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)】：R655.8;R816.8;R445.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 舒松;周坤;;鉬靶X線攝影對乳腺癌的診斷價(jià)值(附82例分析)[J];醫(yī)學(xué)綜述;2014年02期

2 曹亮;周學(xué)軍;趙金麗;吳曉穎;葛涌錢;;3.0T乳腺擴(kuò)散加權(quán)成像中b值的選擇[J];中國醫(yī)療設(shè)備;2013年08期

3 張敏璐;黃哲宙;鄭瑩;;中國2008年女性乳腺癌發(fā)病、死亡和患病情況的估計(jì)及預(yù)測[J];中華流行病學(xué)雜志;2012年10期

4 呂亞萍;毛勤香;馬雪梅;孫嗣麒;黃忠道;;簡易乳腺支架配合SPINE matrix線圈在MRI檢查乳腺中的應(yīng)用[J];醫(yī)學(xué)影像學(xué)雜志;2010年11期

5 李艷玲;李潔;曹];崔涌;李曉婷;張曉鵬;;乳腺癌動(dòng)態(tài)增強(qiáng)MRI特征:非腫塊樣強(qiáng)化與腫塊樣強(qiáng)化的比較[J];中國醫(yī)學(xué)影像技術(shù);2010年07期

6 阮正敏;趙斌;盛華強(qiáng);田興松;;乳腺癌的MRI和X線鉬靶攝影對照研究[J];中國現(xiàn)代普通外科進(jìn)展;2007年06期

7 湯光宇;肖湘生;劉勇;姚冀平;李偉;趙文榮;李彭;;乳腺病變動(dòng)態(tài)增強(qiáng)MRI與血管生成的相關(guān)性[J];中華放射學(xué)雜志;2007年11期

8 顧雅佳;汪曉紅;肖勤;楊文濤;曾煒;唐峰;毛健;鄭曉靜;彭衛(wèi)軍;馮曉源;;乳腺導(dǎo)管原位癌及其微浸潤的磁共振成像評價(jià)[J];中華放射學(xué)雜志;2007年03期

9 顧雅佳;肖勤;鄭曉靜;吳炅;陳佳藝;顧容豐;馮曉源;;乳腺癌保乳治療后的X線隨訪[J];中華放射學(xué)雜志;2006年04期

10 趙斌,蔡世峰,高佩虹,彭洪娟;MR擴(kuò)散加權(quán)成像鑒別乳腺良惡性病變的研究[J];中華放射學(xué)雜志;2005年05期

相關(guān)會(huì)議論文 前1條

1 李瑞敏;彭衛(wèi)軍;顧雅佳;;定量動(dòng)態(tài)增強(qiáng)磁共振鑒別乳腺良惡性病變的研究[A];中華醫(yī)學(xué)會(huì)第十八次全國放射學(xué)學(xué)術(shù)會(huì)議論文匯編[C];2011年

，

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