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  本文選題：乳腺全容積成像技術(shù) + 乳腺超聲��； 參考：《大連醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:1.通過對乳腺腫物進(jìn)行ABVS(Automated Breast Volume Scan)乳腺自動全容積成像技術(shù)檢查,探討ABVS檢查對乳腺良性、惡性腫物診斷的準(zhǔn)確性、特異性及敏感性。2.探討ABVS檢查對乳腺良、惡性疾病診斷的影像學(xué)特點(diǎn)及診斷意義。3.探討ABVS檢查的特征與乳腺惡性腫瘤臨床病理特征的關(guān)聯(lián)性。方法:收集大連醫(yī)科大學(xué)附屬第一醫(yī)院2015年1月~2016年1月乳腺外科收治的乳腺腫瘤患者病案資料,收集患者在我院進(jìn)行ABVS檢查的數(shù)據(jù)資料,建立數(shù)據(jù)庫。進(jìn)行手術(shù)病理檢查明確患者納入統(tǒng)計(jì)。共496例,528枚腫物,平均年齡(47.08±13.92)歲。將臨床資料收集整理后輸入于Filemaker Pro13.0建立的數(shù)據(jù)庫進(jìn)行各因素分類、分組。進(jìn)行統(tǒng)計(jì)分析。計(jì)算ABVS對乳腺腫瘤診斷的準(zhǔn)確性、敏感性、特異性。統(tǒng)計(jì)采用SPSS(statistical package for the social sciences)22.0軟件,以P0.05作為具有顯著性差異的評判標(biāo)準(zhǔn)。結(jié)果:1、ABVS檢查對乳腺良性、惡性腫物診斷的準(zhǔn)確性:(1)從超聲形態(tài)上,鑒別良惡性腫瘤的特異度(82.97%)、敏感度(73.62%),符合率(87.54%)。(2)從超聲飽滿度上,鑒別良惡性腫瘤的特異度(86.54%)、敏感度(91.25%),符合率(80.21%)。(3)從超聲邊界上,鑒別良惡性腫瘤的特異度(81.54%)、敏感度(86.23%),符合率(83.65)%。(4)從超聲邊緣上,鑒別良惡性腫瘤的特異度(84.52%)、敏感度(94.15)%,符合率(82.21%)。(5)從超聲回聲上,鑒別良惡性腫瘤的特異度(86.54%)、敏感度(81.42%),符合率(86.54%)。(6)從超聲是否伴有微鈣化上,鑒別良惡性腫瘤的特異度(81.52%)、敏感度(87.85%),符合率(87.74%)。(7)從超聲是否伴有血流上,鑒別良惡性腫瘤的特異度(86.52%)、敏感度(92.45%),符合率(89.54%)。(8)從ABVS橫斷面邊緣上,鑒別良惡性腫瘤的特異度(91.65%)、敏感度(90.12%),符合率(92.52%)。(9)從ABVS冠狀面上,鑒別良惡性腫瘤的特異度(92.52%)、敏感度(93.13%)符合率(92.54),準(zhǔn)確指數(shù)(0.54)。2、乳房惡性腫瘤患者病理特征與ABVS影像特點(diǎn)之間關(guān)聯(lián)性如下:1、ER與形態(tài)、邊界、飽滿、邊緣、微鈣化、匯聚征有關(guān),P0.05差異有統(tǒng)計(jì)學(xué)意義;2、PR與形態(tài)、邊界、飽滿、邊緣、微鈣化、匯聚征、血流有關(guān),P0.05差異有統(tǒng)計(jì)學(xué)意義;3、HER-2與形態(tài)、飽滿、邊緣有關(guān),P0.05差異有統(tǒng)計(jì)學(xué)意義;4、CK5/6與形態(tài)、邊界、飽滿、微鈣化有關(guān)P0.05差異有統(tǒng)計(jì)學(xué)意義;5、EGFR與形態(tài)、飽滿、微鈣化、匯聚征有關(guān),P0.05差異有統(tǒng)計(jì)學(xué)意義;6、軟組織浸潤與邊界、飽滿、邊緣有關(guān),P0.05差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:1、應(yīng)用ABVS進(jìn)行乳腺腫物檢查所呈現(xiàn)的各聲像學(xué)特征,尤其是冠狀面特征,對鑒別良惡性腫瘤的特異度、敏感度、符合率均較高。因此將乳腺全容積成像技術(shù)應(yīng)用在乳腺良惡性疾病診斷過程中具有較高的應(yīng)用價值,可將其視為乳腺良惡性疾病的有效診斷措施。2、乳房惡性腫瘤患者病理特征與ABVS影像特點(diǎn)之間有一定關(guān)聯(lián)性。對患者預(yù)后有一定提示。
[Abstract]:Purpose 1.The accuracy, specificity and sensitivity of ABVS(Automated Breast Volume scan in the diagnosis of benign and malignant breast masses were discussed.To explore the imaging features and diagnostic significance of ABVS in the diagnosis of benign and malignant breast diseases.To explore the correlation between the features of ABVS and the clinicopathological features of breast malignant tumors.Methods: the medical records of breast tumor patients admitted in the first affiliated Hospital of Dalian Medical University from January 2015 to January 2016 were collected. The data of ABVS examination were collected and the database was established.The patients were included in the statistics by surgical and pathological examination.The mean age was 47.08 鹵13.92 years.The clinical data were collected and sorted into the database established by Filemaker Pro13.0.Carry on statistical analysis.The accuracy, sensitivity and specificity of ABVS in the diagnosis of breast tumors were calculated.SPSS(statistical package for the social sciences)22.0 software was used, and P0.05 was taken as the criterion of significant difference.Results the diagnostic accuracy of the ABVS examination for benign and malignant breast masses was 82.97%, 73.62%, 82.97%, 73.62% and 87.54%, respectively.) from the aspect of ultrasound, the accuracy of the diagnosis of benign and malignant breast masses was 82.97%, and the coincidence rate was 87.54%. (2) from the aspect of ultrasonic plumpness, the accuracy of ABVS in the diagnosis of benign and malignant breast masses was 82.97%.The specificity of differentiating benign and malignant tumors is 86.54. The sensitivity is 91.250.The coincidence rate is 80.21. From the boundary of ultrasound, the specificity of differentiating benign and malignant tumors is 81.54. The sensitivity is 86.23. The coincidence rate is 83.65.The specificity of differentiating benign and malignant tumors is 84.52 and the sensitivity is 94.15. The coincidence rate is 82.21. On the echo of ultrasound, the specificity of benign and malignant tumors is 86.54. The sensitivity is 81.42. The coincidence rate is 86.54.The specificity of differentiating benign and malignant tumors was 81.52 and the sensitivity was 87.855.The coincidence rate was 87.747.740.The specificity of ultrasound was 86.52%, and the sensitivity was 92.455.The coincidence rate was 89.540.88) from the edge of ABVS cross section.The specificity of the differential diagnosis of benign and malignant tumors was 91.65%, the sensitivity was 90.12%, the coincidence rate was 92.522%) from the coronal plane of ABVS,The specificity of differential diagnosis of benign and malignant tumors was 92.52% and sensitivity was 93.13%.) the coincidence rate was 92.54 and the accurate index was 0.54. The correlation between pathological features and ABVS imaging features of breast malignant tumors was as follows: 1 / 1 ER and morphology, boundary, fullness, margin, microcalcification, and microcalcification.There were significant differences in convergence sign (P0.05) between PR and morphology, border, fullness, edge, microcalcification, convergence sign, blood flow related difference (P0.05). There was significant difference between HER-2 and shape, fullness, and significant difference in edge (P 0.05) about CK5 / 6 and morphology.There were significant differences in the boundary, fullness, microcalcification (P0.05) and morphology (P0.05), plump, micro-calcification (P05), convergence (P0.05), soft tissue infiltration and boundary, fullness (P0.05), edge (P0.05).Conclusion the sonographic features, especially the coronal features, of ABVS for breast mass examination are of high specificity, sensitivity and coincidence in differentiating benign and malignant tumors.Therefore, the application of full volume mammography in the diagnosis of benign and malignant breast diseases has a higher application value.It can be regarded as an effective method for the diagnosis of benign and malignant breast diseases. There is a certain correlation between the pathological features of breast malignant tumors and the features of ABVS images.There are some indications for the prognosis of the patients.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R445.1;R737.9

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