發(fā)布時間：2018-03-21 02:04

  本文選題：自動乳腺全容積掃描　切入點：冠狀面　出處：《復旦大學》2014年碩士論文　論文類型：學位論文

【摘要】：第一部分：乳腺占位性病變自動乳腺全容積掃描冠狀面成像特征目的探討自動乳腺全容積掃描(automated breast volume scanner, ABVS)冠狀面成像在乳腺占位性病變診斷及鑒別診斷中的價值。方法選取我院手術(局部切除術或根治術)病理證實的130例女性患者,共138個(良性85個,惡性53個)乳腺病灶,從腫塊自身表現(xiàn)(邊界、邊緣輪廓及包膜)和周邊組織特征(無變化、匯聚征、低回聲暈及高回聲暈)兩大方面分析病灶ABVS冠狀面成像特征。通過x2檢驗得出對乳腺占位性病變鑒別診斷有價值的冠狀面征象。結果1.浸潤性乳腺癌、纖維腺瘤及乳腺病在ABVS冠狀面的主要特征在ABVS冠狀面上,浸潤性乳腺癌主要表現(xiàn)為邊界模糊(39/53,73.6%)、邊緣蟲蝕征(38/53,71.7%)、無包膜(52/53,98.1%)、周邊組織匯聚征(27/53,50.9%)；纖維腺瘤主要表現(xiàn)為邊界清晰(58/60,96.7%)、邊緣光滑(46/60,76.7%)、周邊組織無明顯變化(45/60,75.0%)：腺病的主要表現(xiàn)和纖維腺瘤相似,包括邊界清晰(18/25,72.0%)、邊緣光滑或欠光滑(20/25,80.0%)、周邊組織無明顯變化(14/25,56.0%)。2.乳腺良惡性病變鑒別診斷(1)蟲蝕征診斷浸潤性乳腺癌的敏感性、特異性分別為71.7%和98.8%；匯聚征診斷浸潤性乳腺癌的敏感性、特異性分別為50.9%和97.6%；聯(lián)合蟲蝕征和匯聚征診斷浸潤性乳腺癌的敏感性、特異性分別為90.6%、97.6%。蟲蝕征、匯聚征以及兩者聯(lián)合診斷浸潤性乳腺癌的ROC曲線下面積分別為0.853、0.743和0.941。(2)把星芒征作為邊界模糊的乳腺病和浸潤性乳腺癌的鑒別診斷標準時,其診斷邊界模糊的乳腺病的敏感性為71.4%,特異性高達98.1%,PPV和NPV分別為83.3%和96.3%。(3)低回聲暈診斷乳腺良性病變敏感性和特異性分別為14.1%和100%。結論ABVS冠狀面成像有助于乳腺占位性病變的診斷及鑒別診斷。第二部分：乳腺浸潤性導管癌自動乳腺全容積掃描冠狀面匯聚征與其臨床病理特征相關性目的探討自動乳腺全容積掃描(automated breast volume scanner, ABVS)冠狀面匯聚征對乳腺浸潤性導管癌(infiltrating ductal carcinoma,IDC)治療敏感性及其預后的預測價值。方法選取于本院行乳腺癌根治性切除術、病理診斷為IDC患者46例,共47個病灶,分析病灶ABVS冠狀面匯聚征與其臨床病理(病灶大小、病理組織學分級、腋窩淋巴結狀態(tài)以及ER、PR、HER2表達)相關性。結果匯聚征在不同大小和不同腋窩淋巴結狀態(tài)IDC組中出現(xiàn)比例差異無明顯統(tǒng)計學意義(P0.05)。匯聚征在病理分級Ⅱ級組中出現(xiàn)的比例高于Ⅲ級組,差異有統(tǒng)計學意義(P=0.01)。匯聚征在ER陽性組出現(xiàn)的比例高于ER陰性組,但差異無統(tǒng)計學意義(P=0.055)；在PR陽性組出現(xiàn)的比例高于PR陰性組,差異具有統(tǒng)計學意義(P=-0.004)；在HER2陰性組出現(xiàn)的比例高于HER2陽性組,差異也具有統(tǒng)計學意義(P=0.036)。結論匯聚征對IDC治療敏感性及其預后有一定的預測價值。
[Abstract]:Part one: characteristics of automatic full volume scanning coronal imaging of breast mass lesions objective to evaluate the value of automatic full volume breast volume imaging in the diagnosis and differential diagnosis of breast occupying lesions. Methods 130 female patients who were pathologically proved by surgery (local excision or radical operation) were selected. A total of 138 breast lesions (85 benign and 53 malignant) were found in the breast, including their own features (boundary, margin, envelope) and surrounding tissue features (no change, convergence sign). Low echo halo and hyperechoic halo) were used to analyze the ABVS coronal imaging features of the lesions. By means of x2 test, valuable coronal features were obtained for the differential diagnosis of breast space occupying lesions. 1. Invasive breast cancer, The main features of fibroadenoma and mammary disease on the coronal plane of ABVS are on the coronal plane of ABVS. The main manifestations of invasive breast cancer are fuzzy border 39 / 53 / 73.6T, marginal worm erosion 38 / 53 / 71.7m, no capsule 52P / 53 / 98.1C, peripheral tissue convergence sign 27 / 53nb / 50.9A; fibroadenoma is characterized by clear boundary 58 / 53 / 6096.7m, smooth edge 4660607R / 77.There is no obvious change in peripheral tissue. 45 / 6075.00: the main manifestation of adenopathy is: adenopathy. The main manifestations of adenopathy are as follows: the main manifestations of adenopathy are as follows: the main manifestations of adenopathy are as follows: the main manifestations of adenopathy are as follows: the main manifestations of adenopathy are as follows: the main manifestations of adenopathy are as follows: the main manifestations of adenopathy are as follows:. Like fibroadenoma, These include clear boundaries of 18 / 25 / 72.0, smooth or unsmooth edges, 20 / 2580.0, and no significant changes in peripheral tissues. The sensitivity of invasive breast cancer is diagnosed by 14 / 2525 / 56.0. 2. Differential diagnosis of benign and malignant breast lesions. (1) the sensitivity of invasive breast cancer. The specificity was 71.7% and 98.8 respectively, the sensitivity of convergence sign in the diagnosis of invasive breast cancer was 50.9% and 97.6.The sensitivity of combined worm erosion sign and convergence sign in the diagnosis of invasive breast cancer was 90.6 and 97.6. The areas under the ROC curve of convergent sign and combined diagnosis of invasive breast cancer were 0.8530.73 and 0.941.2respectively) when the star sign was used as the differential diagnostic criterion for breast disease with fuzzy boundary and invasive breast cancer, the area under the ROC curve was 0.8530.43 and 0.941.2respectively. The sensitivity and specificity of hypoechoic halo in the diagnosis of breast benign lesions were 71.4 and 98.1respectively. The sensitivity and specificity of hypoechoic halo in the diagnosis of benign breast lesions were 14.1% and 1000.Conclusion ABVS coronal imaging is helpful in the diagnosis of mammary gland. Diagnosis and differential diagnosis of positional lesions. Part 2: coronal convergence sign of automatic full volume scanning of breast and its clinicopathological features objective to investigate the correlation between automatic full volume scan of breast breast volume scanner (ABVS). The value of coronal convergence sign in the treatment of infiltrating ductal carcinoma of breast and its prognostic value. Methods radical mastectomy was performed in our hospital. 46 patients (47 lesions) with IDC were diagnosed by pathology. The coronal convergence sign of ABVS and its clinicopathological features (size of lesion, histopathological grade) were analyzed. Results there was no significant difference in the proportion of convergence sign in IDC group with different size and different axillary lymph node status (P 0.05). The convergence sign appeared in pathological grade 鈪，

本文編號：1641773