本文選題：乳腺導(dǎo)管內(nèi)癌　切入點(diǎn)：多模態(tài)超聲　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過分析乳腺導(dǎo)管內(nèi)癌的多模態(tài)超聲表現(xiàn),評(píng)價(jià)多模態(tài)超聲檢查對(duì)乳腺導(dǎo)管內(nèi)癌的應(yīng)用價(jià)值;探討多模態(tài)超聲定位引導(dǎo)乳腺導(dǎo)管內(nèi)癌活檢的臨床價(jià)值。方法:回顧性分析2014年8月至2017年1月在廣西醫(yī)科大學(xué)附屬腫瘤醫(yī)院乳腺外科住院在多模態(tài)超聲定位引導(dǎo)活檢的75例乳腺導(dǎo)管內(nèi)癌患者75個(gè)病灶的臨床資料及病理組織學(xué)診斷結(jié)果,均為女性,年齡26-70歲,平均年齡(47.38±11.01)歲�；顧z前行多模態(tài)超聲(常規(guī)超聲、彩色多普勒超聲、螢火蟲技術(shù)、全景成像技術(shù)、彈性成像技術(shù))檢查。75例乳腺導(dǎo)管內(nèi)癌患者均在多模態(tài)超聲定位引導(dǎo)活檢,活檢標(biāo)本進(jìn)行病理檢查。借鑒ACR提出的BI-RADS分類規(guī)范記錄評(píng)分,對(duì)檢查結(jié)果做出初步分類;病灶血供分級(jí)參照Alder半定量法;彈性評(píng)分參考羅葆明改良5分法;采用SPSS 19.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)統(tǒng)計(jì),采用Pearson相關(guān)分析進(jìn)行相關(guān)分析,以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1、DCIS多模態(tài)超聲分類腫塊型72例,其中伴微鈣化47例,單純鈣化型3例。BI-RADS 4類為69例,占92.00%(69/75),3例為BI-RADS3類,占4.00%(3/75),BI-RADS 0類為3例,占4.00%(3/75)。腫塊型中平行生長(zhǎng)為72例,占100.00%(72/72);形態(tài)不規(guī)則為69例,占95.83%(69/72);邊緣不完整為65例,占90.28%(65/72);伴有微鈣化為47例,占65.28%(47/72);后方回聲衰減為15例,占20.83%(15/72);血供豐富為54例,占75.00(54/72);UE評(píng)分4分為64例,占88.89%(64/72),結(jié)果提示DCIS以質(zhì)軟為主;多模態(tài)超聲測(cè)量DCIS病灶直徑與術(shù)后大體病灶直徑的相關(guān)系數(shù)為0.948,有統(tǒng)計(jì)學(xué)意義(P=0.000)。2、72例腫塊型采用多模態(tài)超聲定位引導(dǎo)穿刺活檢,均一次性取材成功取得病理結(jié)果,無明顯并發(fā)癥發(fā)生;3例單純微鈣化型采用多模態(tài)超聲引導(dǎo)鋼絲定位手術(shù)活檢,均一次性取材成功取得病理結(jié)果,無鋼絲移位、折斷、脫落�；顧z病理結(jié)果DCIS-MI為30例,占40.00%(30/75),DCIS為45例,占60.00%(45/75)。結(jié)論:1、DCIS多模態(tài)超聲多表現(xiàn)為平行生長(zhǎng)、形態(tài)不規(guī)則、邊緣不完整、伴有微鈣化、血供豐富及病灶質(zhì)軟,提高對(duì)DCIS的認(rèn)識(shí)對(duì)其早期診斷具有重要的指導(dǎo)意義和應(yīng)用價(jià)值。2、多模態(tài)超聲定位引導(dǎo)DCIS活檢,取材成功率高,有助于DCIS的早期診斷。
[Abstract]:Objective: to evaluate the value of multimodal ultrasonography in breast intraductal carcinoma by analyzing its findings. Objective: to evaluate the clinical value of multimodal ultrasound guided biopsy of breast intraductal carcinoma. Methods: retrospective analysis was conducted in breast surgery hospital affiliated to Guangxi Medical University from August 2014 to January 2017. Clinical data and histopathological diagnosis of 75 lesions in 75 patients with breast intraductal carcinoma. All of them were female, aged 26 to 70 years, with an average age of 47.38 鹵11.01 years. Multimodal ultrasound (conventional ultrasound, color Doppler ultrasound, firefly technique, panoramic imaging) was performed before biopsy. All the 75 cases of breast intraductal carcinoma were examined by multi-mode ultrasound guided biopsy, and the biopsy specimens were examined by pathology. The results were preliminarily classified according to the score of BI-RADS classification standard put forward by ACR. According to Alder semi-quantitative method, elastic score reference Luo Baoming's improved 5-score method, SPSS 19.0 statistical software was used for data statistics, and Pearson correlation analysis was used for correlation analysis. Results there were 72 cases of mass type with microcalcification, 69 cases with BI-RADS 4, 3 cases with BI-RADS 4, 3 cases with BI-RADS3, and 3 cases with 4.000.75% BI-RADS 0. There were 72 cases of parallel growth in mass type, accounting for 100.007 / 72% of 72 cases; 69 cases of irregular shape, accounting for 95.83% of 72%; 65 cases of marginal incompleteness, accounting for 90.28% of 6572%; 47 cases of microcalcification with microcalcification, accounting for 65.28% of 47%; 15 cases of back echo attenuation, accounting for 20.833% -72%; 54 cases of abundant blood supply. The UE score of 75.00 / 54 / 72 was divided into 64 cases, accounting for 88.89% and 64% of 72%. The results showed that the quality of DCIS was mainly soft. The correlation coefficient between the diameter of DCIS lesion and the diameter of gross lesion after operation was 0.948 by multimodal ultrasound. There was statistical significance in 72 cases of mass type guided by multi-mode ultrasound, and the pathological results were obtained successfully in one time. There were no obvious complications in 3 cases of simple microcalcification with multi-mode ultrasound guided steel wire localization biopsy. The pathological results were obtained successfully in one time, no steel wire displacement, fracture, and exfoliation. The pathological results of biopsy were DCIS-MI in 30 cases. There were 45 cases with DCIS of 30% of 45% (60.005 / 75%). Conclusion the multimodal ultrasound of 10: 1 is characterized by parallel growth, irregular shape, incomplete margin, microcalcification, abundant blood supply and soft lesions. Improving the understanding of DCIS has important guiding significance and application value for early diagnosis. Multi-mode ultrasound guided DCIS biopsy is helpful to the early diagnosis of DCIS.
【學(xué)位授予單位】：廣西醫(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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