本文選題：超聲組織彈性成像 + 乳腺腫塊　； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的： 通過(guò)測(cè)定乳腺腫塊的二維超聲（Two-dimensional Ultrasound）及超聲組織彈性成像（Ultrasonicelastography，UE）參數(shù)，分析研究超聲組織彈性成像（Ultrasonic elastography，UE）技術(shù)對(duì)乳腺腫塊良惡性的診斷價(jià)值。 資料與方法： 選取我院乳腺外科2012年3月至2013年6月收治的76例就診女患者為基礎(chǔ)研究對(duì)象。所有入組對(duì)象均經(jīng)病理證實(shí)，，76例患者中共106個(gè)乳腺腫塊。研究對(duì)象中乳腺腫塊最大直徑均不足5.0cm，術(shù)前未接受任何化療與放療，均經(jīng)常規(guī)二維超聲（2D-US）進(jìn)行檢查，并切換到超聲彈性成像模式，操作時(shí)將感興趣區(qū)調(diào)節(jié)到大致腫塊面積2倍左右，根據(jù)顯示屏上的質(zhì)量指數(shù)（QF），以QF＞50-75為圖像質(zhì)量可信的標(biāo)準(zhǔn)進(jìn)行檢查。術(shù)后均經(jīng)病理結(jié)果對(duì)照。所得檢測(cè)結(jié)果均進(jìn)行3次重復(fù)檢查、應(yīng)用彩色多普勒血流成像（CDFI）、德國(guó)西門(mén)子公司的Acuson S2000超聲診斷儀彈性成像檢查并取腫瘤直徑平均數(shù)進(jìn)行統(tǒng)計(jì)，對(duì)所得乳腺腫塊間數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析，采用X2檢驗(yàn)，經(jīng)SPSS14.0軟件進(jìn)行分析，結(jié)果以p＜0.05表示差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果 1106個(gè)乳腺腫塊組織病理學(xué)金標(biāo)準(zhǔn)診斷結(jié)果：79個(gè)良性腫塊，27個(gè)惡性腫塊。 2常規(guī)二維超聲診斷乳腺腫塊良惡性的靈敏性為81.48%（22/27）、特異性68.35（%54/79）、準(zhǔn)確性71.70%（76/106）、陽(yáng)性預(yù)測(cè)值91.53%（54/59）、陰性預(yù)測(cè)值46.81%（22/47）。 3UE評(píng)分診斷79個(gè)良性病灶中，3級(jí)以下62個(gè)78.48%（62/79），4級(jí)以上17個(gè)21.52%（17/79）；27個(gè)惡性病灶中，3級(jí)以下5個(gè)18.52%（5/27），4級(jí)以上22個(gè)81.48%（22/27）。 4常規(guī)二維超聲與UE聯(lián)合診斷靈敏性92.59%（25/27）、特異性94.94%（75/79）、準(zhǔn)確性96.23%（102/106）、陽(yáng)性預(yù)測(cè)值97.40%（75/77）、陰性預(yù)測(cè)值86.21%（25/29）。 結(jié)論： 1常規(guī)二維超聲診斷、超聲組織彈性成像評(píng)分、常規(guī)二維超聲診斷聯(lián)合超聲組織彈性成像評(píng)分這三種方法對(duì)乳腺腫塊良惡性的診斷均具有一定臨床價(jià)值，但是單純應(yīng)用其中一種方法進(jìn)行診斷乳腺腫塊良惡性與敏感性之間差異無(wú)明顯統(tǒng)計(jì)學(xué)意義（p＞0.05）。 2聯(lián)合診斷對(duì)乳腺腫塊良惡性的敏感性、準(zhǔn)確性、特異性均顯著高于單獨(dú)應(yīng)用2D及UE診斷結(jié)果。 3三種方法陽(yáng)性預(yù)測(cè)值間有統(tǒng)計(jì)學(xué)意義（p＜0.05），但陰性預(yù)測(cè)值間無(wú)統(tǒng)計(jì)學(xué)意義（p＞0.05）。 4雖然超聲組織彈性成像技術(shù)聯(lián)合診斷方法在評(píng)定乳腺癌中有一定差異，但是其在診斷乳腺腫塊的良惡性方面上價(jià)值是不可置疑的。
[Abstract]:Objective: By measuring the parameters of Two-dimensional Ultrasound and Ultrasound elastography in breast masses, the diagnostic value of ultrasonic elastography and ultrasonic elastography in diagnosis of breast masses was studied. Information and methods: From March 2012 to June 2013, 76 female patients in our department of breast surgery were selected as basic research objects. A total of 106 breast masses were confirmed by pathology in 76 patients. The maximum diameters of breast masses were less than 5.0 cm. No chemotherapy and radiotherapy were performed before the study. They were examined by conventional two-dimensional ultrasonography (2D-USS) and switched to the mode of ultrasound elastic imaging. During operation, the area of interest was adjusted to about 2 times of the area of the mass. According to the quality index on the display screen, QF > 50-75 was used as the reliable standard of image quality. Postoperative pathological results were compared. The results were all repeated three times. The color Doppler flow imaging (CDFI) and the Acuson S2000 ultrasonic diagnostic instrument of Siemens Company of Germany were used to examine the results of elastic imaging, and the mean diameter of the tumor was calculated. The data of breast masses were statistically analyzed by X2 test and analyzed by SPSS14.0 software. The results showed that the difference was statistically significant with p < 0. 05. Result The diagnostic results of 1106 breast masses were as follows: 79 benign masses and 27 malignant masses. 2the sensitivity of conventional two-dimensional ultrasound in the diagnosis of benign and malignant breast masses was 81.48 and 22 / 27, the specificity was 68.35 / T / 79, the accuracy was 71.70 / 106, the positive predictive value was 91.53 / 59 and the negative predictive value was 46.81 / 47. Of the 79 benign lesions diagnosed by 3UE score, 62 were below 78.48 and 17 were above 62 / 79 / 4, 17 / 21.52 / 79 / 79, and 5 of 27 malignant lesions were below grade 3 and 5 18. 52 / 27 / 4, 22 / 81.48 were 22 / 27 / 27. (4) the sensitivity of conventional two-dimensional ultrasound combined with UE is 92.599.25 / 27, the specificity is 94.94 and 75 / 79, the accuracy is 96.23 / 102 / 106, the positive predictive value is 97.40 / 77 and the negative predictive value is 86.21 / 25 / 29. Conclusion: 1 the three methods of conventional two-dimensional ultrasound diagnosis, ultrasonic tissue elastic imaging score and conventional two-dimensional ultrasound diagnosis combined with ultrasound tissue elastic imaging score have certain clinical value in the diagnosis of breast masses. However, there was no significant difference in sensitivity between benign and malignant breast masses by using one of the methods alone (P > 0.05). 2 the sensitivity, accuracy and specificity of combined diagnosis for benign and malignant breast masses were significantly higher than those for 2D and UE alone. 3There was significant difference between the positive predictive values of the three methods (p < 0.05), but there was no significant difference between the negative predictive values and the positive predictive values (P > 0.05). 4 although there are some differences in the diagnosis of breast cancer with ultrasonic tissue elastography, its value in the diagnosis of benign and malignant breast masses is indisputable.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R737.9;R445.1

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