本文選題：乳腺病變 + 超聲檢查�。� 參考：《新鄉(xiāng)醫(yī)學院》2017年碩士論文

【摘要】：目的:分析超聲實時彈性成像整體應變率比值和局部應變率比值診斷乳腺良惡性病灶的最佳臨界值,比較超聲實時彈性成像整體應變率比值和局部應變率比值的診斷價值,并與超聲“螢火蟲”技術診斷結果進行比較,探討超聲“螢火蟲”技術聯(lián)合超聲實時彈性成像診斷乳腺良惡性病灶的價值和意義,為提高超聲對乳腺良惡性病灶的鑒別診斷水平提供參考和幫助。方法:選取于2015年6月~2016年6月因乳房腫塊就診的94例女性患者為研究對象,經病理確診為良性病灶74個,惡性病灶30個。均采用東芝Aplio500彩色多普勒超聲檢測儀分別以超聲實時彈性成像和“螢火蟲”技術進行病灶檢查,以病理結果為金標準,繪制ROC曲線,并以曲線下面積(Area under Curve,AUC)比較局部應變率比值、整體應變率比值診斷乳腺良惡性病灶的結果。分別采用“螢火蟲”技術、超聲實時彈性成像技術和兩種技術聯(lián)合檢測對乳腺腫塊進行檢查,以病理結果為金標準進行比較,比較不同檢查方式診斷乳腺良惡性病灶的準確性、特異性和敏感性。結果:良性病灶局部應變率比值和整體應變率比值均低于惡性病灶,比較差異均具有統(tǒng)計學意義(P0.05)。局部應變率比值和整體應變率比值的AUC分別為0.92和0.85,最佳臨界點為31.14和3.14,兩者診斷乳腺良惡性病灶的敏感度、特異度、準確性分別為84.6%、80.0%、86.5%和69.2%、63.3%、71.6%。局部應變率比值對乳腺良惡性病灶的診斷價值優(yōu)于整體應變率比值,比較具有統(tǒng)計學差異(P0.05)。超聲“螢火蟲”技術和實時彈性成像診斷良惡性病灶的準確性、特異度及敏感度分別為86.5%、80.0%、89.2%和84.6%、76.7%、87.8%,兩者聯(lián)合檢測的準確性、特異度及敏感度分別為96.2%、93.3%、97.3%�！拔灮鹣x”技術診斷、超聲實時彈性成像診斷的敏感度和準確性均高于鉬靶X線攝影技術,特異度低于鉬靶X線攝影技術,但比較差異均無統(tǒng)計學意義(P0.05)。聯(lián)合檢測的準確性、敏感度與超聲“螢火蟲”技術、實時彈性成像診斷和鉬靶X線攝影技術比較均具有統(tǒng)計學差異(P0.05),聯(lián)合檢測的特異度最高,但與超聲“螢火蟲”技術和實時彈性成像檢測的特異度比較均無統(tǒng)計學差異(P0.05)。結論:超聲實時彈性成像整體應變率比值和局部應變率比值對乳腺良惡性病灶均有重要的診斷價值,其中局部應變率比值的診斷價值更高,優(yōu)于整體應變率比值的診斷價值;聯(lián)合超聲實時彈性成像和“螢火蟲”技術對乳腺良惡性病灶進行診斷,準確性、特異度及敏感度明顯提高,具有較高的診斷價值。
[Abstract]:Objective: to analyze the optimal critical value of the ratio of global strain rate and local strain rate for diagnosis of benign and malignant breast lesions, and to compare the diagnostic value of the ratio of global strain rate and local strain rate in real-time ultrasound elastography. Compared with the diagnostic results of ultrasonic "firefly" technique, the value and significance of ultrasonic "firefly" technique combined with ultrasound real-time elastic imaging in the diagnosis of benign and malignant breast lesions were discussed. To improve the ultrasonic diagnosis of benign and malignant breast lesions to provide reference and help. Methods: 94 female patients with breast masses from June 2015 to June 2016 were selected as study subjects. 74 benign lesions and 30 malignant lesions were confirmed by pathology. Toshiba Aplio500 color Doppler ultrasound instrument was used to detect the lesions by real-time elastic imaging and "firefly" technique, and the ROC curve was drawn according to the pathological results as gold standard. The local strain rate ratio and the global strain rate ratio were compared with the area under current ratio under the curve for the diagnosis of benign and malignant breast lesions. Firefly technique, real-time elastography and two techniques were used to detect breast masses respectively. The accuracy of different examination methods in the diagnosis of benign and malignant breast lesions was compared by using pathological results as gold standard. Specificity and sensitivity. Results: the ratio of local strain rate and global strain rate of benign lesions was lower than that of malignant lesions, and the difference was statistically significant (P 0.05). The AUC of local strain rate ratio and global strain rate ratio were 0.92 and 0.85, respectively, and the best critical points were 31.14 and 3.14 respectively. The sensitivity, specificity and accuracy of the local strain rate ratio and the global strain rate ratio in the diagnosis of benign and malignant breast lesions were 84.6% and 63.3%, respectively. The value of local strain rate ratio in the diagnosis of benign and malignant breast lesions was better than that of overall strain rate ratio, and the difference was statistically significant (P 0.05). The accuracy, specificity and sensitivity of ultrasonic "firefly" technique and real time elastic imaging in the diagnosis of benign and malignant lesions were 86.50.The specificity and sensitivity were 86.2% and 84.6%, respectively. The accuracy, specificity and sensitivity of the combined detection were 96.2% and 93.3%, respectively. The diagnostic sensitivity and accuracy of "Firefly" technique was higher than that of molybdenum target radiography, and the specificity was lower than that of molybdenum target radiography, but there was no significant difference between them. The accuracy and sensitivity of the combined detection were significantly different from those of the ultrasonic "firefly" technique, real-time elastic imaging diagnosis and mammography. The specificity of the combined detection was the highest. But there was no significant difference between the specificity of ultrasonic firefly and real-time elastic imaging. Conclusion: the ratio of global strain rate and local strain rate in real-time ultrasound imaging has important diagnostic value for benign and malignant breast lesions, and the value of local strain rate ratio is higher than that of global strain rate ratio. Combined with real-time elastography and firefly technique, the accuracy, specificity and sensitivity of the diagnosis of benign and malignant breast lesions are significantly improved, which is of great value in the diagnosis of benign and malignant breast lesions.
【學位授予單位】：新鄉(xiāng)醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R445.1;R737.9

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