本文選題：剪切波　切入點(diǎn)：新算法　出處：《鄭州大學(xué)》2014年碩士論文

【摘要】：背景與目的 剪切波彈性成像技術(shù)（shear wave elastography，SWE）是一種新的組織應(yīng)變成像技術(shù)，作為一項(xiàng)直觀、定量的超聲檢查新技術(shù)，SWE已廣泛應(yīng)用于乳腺結(jié)節(jié)良惡性的鑒別診斷。以往文獻(xiàn)報(bào)道乳腺結(jié)節(jié)在彈性模式下二維面積與彈性面積的大小具有較大的差異，主要表現(xiàn)在彈性模式下惡性結(jié)節(jié)的彈性圖面積大于二維圖像，而良性結(jié)節(jié)時(shí)兩者面積相近。因此得出不同性質(zhì)的圖像結(jié)節(jié)在彈性和二維聲像圖中面積有差異，成為鑒別乳腺結(jié)節(jié)良惡性的良好有力指標(biāo)。本研究將通過SWE技術(shù)定量測量病變內(nèi)部及周邊區(qū)域的楊氏模量值，定量評價(jià)其在乳腺實(shí)性結(jié)節(jié)良惡性鑒別診斷中的價(jià)值。 材料與方法 采用SuperSonic Imagine AixPlorer型SWE超聲診斷儀，應(yīng)用實(shí)時(shí)剪切波彈性成像技術(shù)，測量56位患者89個乳腺結(jié)節(jié)內(nèi)部楊氏模量平均值（Emean）、最大值（Emax）、標(biāo)準(zhǔn)差（SD）及結(jié)節(jié)周邊的Emean（以結(jié)節(jié)二維面積的0.37倍腺體為結(jié)節(jié)周邊部分），以病理結(jié)果為“金標(biāo)準(zhǔn)”，繪制ROC曲線，，判斷其診斷價(jià)值。 結(jié)果 ①良性組：結(jié)節(jié)內(nèi)部Emean、Emax及SD分別為：（37.65±7.99）kPa、（81.82±12.78）kPa、（19.69±6.16）kPa，結(jié)節(jié)周邊Emean為：（33.29±10.19）kPa，惡性組：結(jié)節(jié)內(nèi)部Emean、Emax及SD分別為：（50.87±17.19）kPa、（114.26±30.02）kPa、（27.92±13.55）kPa，結(jié)節(jié)周邊Emean為：（73.26±22.49）kPa.良惡性病灶結(jié)節(jié)內(nèi)部Emean、Emax及SD差異均有統(tǒng)計(jì)學(xué)意義（P＜0.05）。良惡性結(jié)節(jié)周邊Emean差異有統(tǒng)計(jì)學(xué)意義。 ②通過繪制ROC曲線，結(jié)節(jié)內(nèi)部Emean、Emax及SD的曲線下面積（AUC）分別為0.736，0.855，0.734，臨界點(diǎn)分別為：40.15kPa，90.5kPa，22.95kPa，結(jié)節(jié)周邊Emean曲線下面積（AUC）為0.940，臨界點(diǎn)為：44.55kPa。 結(jié)論 結(jié)節(jié)內(nèi)部Emean、Emax及SD可為乳腺結(jié)節(jié)良、惡性的鑒別診斷提供依據(jù)，結(jié)節(jié)周邊Emean的測量為乳腺結(jié)節(jié)良、惡性的鑒別提供了一種新的方法，優(yōu)于結(jié)節(jié)內(nèi)部Emean、Emax及SD。
[Abstract]:Background and purpose. Shear wave elastography is a new tissue strain imaging technique, which can be used as an intuitionistic method. The new quantitative ultrasound technique has been widely used in the differential diagnosis of benign and malignant breast nodules. The main manifestation is that the area of elastic image of malignant nodules is larger than that of two-dimensional images in elastic mode, but the area of benign nodules is the same. Therefore, it is concluded that there are differences in the areas of elastic and two-dimensional sonographic images of the nodules with different properties. This study will quantitatively measure the Young's modulus in the inner and peripheral areas of breast lesions by SWE technique and evaluate its value in the differential diagnosis of benign and malignant breast nodules. Materials and methods. Using SuperSonic Imagine AixPlorer SWE ultrasonic diagnostic instrument and real time shear wave elastic imaging technology, The average value of Young's modulus in 89 breast nodules was measured in 56 patients. The mean value of Young's modulus, the maximum value of Emaxus, and the standard deviation were measured. The ROC curves were plotted around the nodules by taking 0.37 times of the two-dimensional area of the nodules as the peripheral parts of the nodules, and using the pathological results as the "gold standard". To judge its diagnostic value. Results. 1 in the benign group, the mean Emax and SD in the inner nodule were 37.65 鹵7.99kPa57.65 鹵7.99kPa. the Emean around the nodule was 19.69 鹵6.16kPa. the Emean around the nodule was 33.29 鹵10.19kPa. in the malignant group, the EmeanEmax and SD were 50.87 鹵17.19kPa114.26 鹵30.02kPa27.92 鹵13.55kPa. the Emean around the nodule was 73.26 鹵22.49kPa.There were significant differences between the benign and malignant nodules (P < 0.05P < 0.05). The difference of Emean around nodules was statistically significant. 2 by drawing the ROC curve, the area under the curve of ROC and SD were 0.734, 0.736and 0.855kParespectively, the critical points were 40.15kPa90.5kPa-22.95kPa. the area under the Emean curve around the nodule was 0.940, and the critical point was: 44.55kPa. Conclusion. Emeanus Emax and SD can provide evidence for the differential diagnosis of benign and malignant breast nodules. The measurement of Emean around the nodules provides a new method for the differential diagnosis of benign and malignant breast nodules, which is superior to that within the nodules.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.1;R737.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前8條

1 W.A.Berg;D.O.Cosgrove;C.J.Doré;F.K.W.Sch

本文編號：1696991