本文選題：聲輻射力脈沖 + 彈性成像�。� 參考：《南昌大學(xué)》2017年碩士論文

【摘要】：目的:1.通過(guò)觀察干燥綜合征(SS)患者唾液腺常規(guī)超聲特征,探討超聲評(píng)分對(duì)SS的診斷的價(jià)值。2.運(yùn)用聲輻射力脈沖(ARFI)技術(shù)測(cè)量SS患者唾液腺硬度,探討ARFI成像對(duì)SS的診斷價(jià)值。方法:收集我院風(fēng)濕免疫科門(mén)診或住院的SS疑診的患者者155例,將患者分為SS組76例和非SS組79例。對(duì)所有患者雙側(cè)腮腺及頜下腺進(jìn)行二維超聲檢查,獲得雙側(cè)腮腺及頜下腺的聲像圖表現(xiàn),采用半定量評(píng)分方法對(duì)其進(jìn)行評(píng)分。隨后對(duì)雙側(cè)腮腺及頜下腺進(jìn)行ARFI檢查,獲得雙側(cè)腮腺及頜下腺的剪切波速度(SWV)。比較兩組間唾液腺超聲評(píng)分及SWV值的差異性并分析其診斷SS的價(jià)值。結(jié)果:1、非SS組中唾液腺超聲64例(64/79,81.0%)表現(xiàn)為正常,評(píng)為0分,而SS組64例(64/76,84.2%)唾液腺超聲評(píng)分≥1分。SS組唾液腺超聲評(píng)分高于非SS組(P0.001)。2、唾液腺超聲評(píng)分診斷SS的ROC曲線下面積為0.883(95%置信區(qū)間0.826,0.940),以2分為臨界值診斷SS靈敏度為73.7%,特異度為94.9%,準(zhǔn)確率為84.5%。3、SS組及非SS組同組內(nèi)雙側(cè)腮腺、頜下腺間SWV值差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);不同組間腮腺及頜下腺SWV值差異均有統(tǒng)計(jì)學(xué)意義(P0.05)4、頜下腺ARFI診斷SS的ROC曲線下面積為0.859(95%置信區(qū)間0.767,0.950),以2.14m/s為臨界值診斷SS靈敏度為76.3%,特異度為84.6%。腮腺ARFI診斷SS的ROC曲線下面積為0.843(95%置信區(qū)間0.741,0.945),以1.98m/s為臨界值診斷SS靈敏度為84.2%,特異度為84.6%。唾液腺ARFI成像診斷SS的最佳截?cái)嘀�、敏感性、特異性、�?zhǔn)確率及ROC曲線下面積分別為2.11 m/s、81.6%、88.5%、85.2%及0.890。5、唾液腺超聲評(píng)分聯(lián)合ARFI成像診斷SS的敏感性、特異性及準(zhǔn)確率分別為95.2%、84.0%、89.0%。結(jié)論:唾液腺超聲評(píng)分法可為唾液腺回聲的均勻程度提供半定量指標(biāo),輔助SS的診斷具有較高的特異度。ARFI成像可以提供唾液腺SWV值,定量反應(yīng)唾液腺?gòu)椥?SS患者的腮腺及頜下腺的硬度高于非SS患者,在SS診斷中具有重要價(jià)值。唾液腺常規(guī)超聲聯(lián)合ARFI成像對(duì)SS的診斷價(jià)值與單一成像相當(dāng)。
[Abstract]:Purpose 1.By observing the characteristics of salivary gland routine ultrasound in patients with Sjogren's syndrome (SS), the value of ultrasonic score in the diagnosis of SS was discussed.The salivary gland hardness of SS patients was measured by acoustic radiation power pulse technique (ARFI), and the diagnostic value of ARFI imaging for SS was discussed.Methods: 155 patients with suspected SS were divided into SS group (n = 76) and non-SS group (n = 79).Two-dimensional ultrasonography was performed on the bilateral parotid and submandibular glands of all patients, and the sonographic features of the bilateral parotid and submandibular glands were obtained and scored by semi-quantitative scoring method.The shear wave velocities of bilateral parotid and submandibular glands were obtained by ARFI.The differences of salivary gland ultrasound score and SWV between the two groups were compared and the diagnostic value of SS was analyzed.Results in the non-SS group, 64 cases of salivary gland ultrasound showed normal results (64 / 79 / 81.0), with a score of 0.The salivary gland ultrasound score of SS group was higher than that of non-SS group (P 0.001). The area under the ROC curve of SS was 0.88395% confidence interval 0.8260.9400.The critical value of SS was 73.7%.The specificity was 94. 9 and the accuracy was 84. 5%. The parotid glands in the same group and non-SS group were 84.5% and 84. 5% respectively.There was no significant difference in SWV value between submandibular glands (P 0.05), and there were significant differences in SWV value of parotid gland and submandibular gland between different groups (P 0.05). The area under ROC curve of ARFI diagnosis of SS in submandibular gland was 0.859% 95% confidence interval 0.7670.95% confidence interval 0.7670.500.The critical value of 2.14m/s was sensitive to diagnose SS.The degree was 76. 3 and the specificity was 84. 6.The area under the ROC curve of parotid gland ARFI diagnosis SS was 0.843 ~ 95% confidence interval 0.741 ~ 0.945%. The sensitivity and specificity of 1.98m/s were 84.2% and 84.6% respectively.The best truncation value, sensitivity, specificity, accuracy and area under the ROC curve of salivary gland ARFI were 2.11 m / s 81.6% and 0.890.5%, respectively. The sensitivity, specificity and accuracy of salivary gland ultrasound score combined with ARFI imaging in the diagnosis of SS were 95.2or 84.0 and 89.0, respectively.Conclusion: the salivary gland ultrasound scoring method can provide a semi-quantitative index for the homogeneity of salivary gland echo. The diagnostic specificity of the adjuvant SS is higher. ARFI imaging can provide the salivary gland SWV value.The hardness of parotid gland and submandibular gland in patients with quantitative response to salivary gland elasticity was higher than that in non-SS patients, which was of great value in the diagnosis of SS.The diagnostic value of salivary gland conventional ultrasound combined with ARFI imaging in SS is similar to that of single imaging.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.1;R593.2

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