超聲彈性成像聯(lián)合BI-RADS-US分類在老年乳腺癌診斷中的應(yīng)用價(jià)值研究
發(fā)布時(shí)間：2019-03-28 06:01
【摘要】：目的： 討論聯(lián)合應(yīng)用超聲彈性成像評(píng)分法和BI-RADS-US分類在乳腺癌診斷中的應(yīng)用價(jià)值。 方法： 研究方法：在2012年1月至2014年4月間,選擇來醫(yī)院乳腺病科就診的老年乳腺占位患者93例共計(jì)127個(gè)腫塊作為研究對(duì)象,患者平均年齡為(68.46±11.51)歲,所有患者均具有最終手術(shù)或穿刺而獲得的病理結(jié)果。對(duì)所有入組患者聯(lián)合應(yīng)用超聲彈性成像評(píng)分法和BI-RADS-US分類檢查進(jìn)行診斷,以乳腺鋁靶檢查為對(duì)照組,經(jīng)病理證實(shí),比較診斷效果。 超聲檢查方法：患者取正常仰臥位,充分暴露雙乳及腋下,應(yīng)用GE E9超聲儀實(shí)時(shí)線陣高頻探頭,探頭頻率6-15MHz。首先進(jìn)行常規(guī)超聲檢查(包括二維、彩色多普勒、頻譜多普勒超聲),觀察病灶內(nèi)部回聲、后方回聲、形態(tài)、邊界、測量大小、縱橫比,了解血供情況,測量血流阻力指數(shù)RI。然后啟動(dòng)彈性成像程序,采用實(shí)時(shí)雙幅模式,彈性成像采用評(píng)分法進(jìn)行診斷,同時(shí)結(jié)合BI-RADS-US分類方法對(duì)病灶進(jìn)行半定量診斷評(píng)價(jià)。 鉬靶檢查方法：患者取立位,乳腺鉬靶X線攝影的儀器為美國通用GEApha ST MGF-101型乳腺鉬靶,對(duì)患者兩側(cè)乳腺內(nèi)外斜位攝影采用軸位及斜位投照,部分病例加照側(cè)位片或病灶局部片通過轉(zhuǎn)化變?yōu)閿?shù)字化影像后進(jìn)行處理。 結(jié)果： 1.超聲彈性成像評(píng)分法和BI-RADS-US分類二者聯(lián)合應(yīng)用在乳腺占位判定良惡性分級(jí)診斷的靈敏度為84.44%,特異度為89.02%,采用χ2檢驗(yàn)分析后,(χ2=67.274,P=0.000),結(jié)果具有統(tǒng)計(jì)學(xué)意義。 2.良惡性腫瘤的二者聯(lián)合應(yīng)用,評(píng)價(jià)診斷分級(jí)圖像與二維圖像面積比(t=5.694,P=0.001)也具有統(tǒng)計(jì)學(xué)意義。 3.超聲彈性成像評(píng)分法和BI-RADS-US分類二者聯(lián)合應(yīng)用在乳腺占位病變中的診斷符合率高于乳腺鉬靶檢查。 結(jié)論： 超聲彈性成像評(píng)分法與BI-RADS-US分類聯(lián)合運(yùn)用,對(duì)病灶進(jìn)行綜合評(píng)價(jià),能夠有助于老年乳腺腫塊患者的良惡性的判定,提高乳腺腫塊的診斷準(zhǔn)確性。
[Abstract]:Objective: to discuss the value of combined ultrasonic elastography and BI-RADS-US classification in the diagnosis of breast cancer. Methods: from January 2012 to April 2014, 93 elderly patients with breast space occupying lesions were selected as the subjects. The average age of the patients was (68.46 鹵11.51) years old, and the mean age of the patients was (68.46 鹵11.51) years old, and the average age of the patients was (68.46 鹵11.51) years old. All patients had final surgical or puncture results. All the patients in the group were diagnosed by ultrasonic elastography and BI-RADS-US classification. The breast aluminum target examination was used as the control group, and the diagnosis results were compared by pathology. Methods: the patients were taken from normal supine position and exposed to both breast and armpit. The real-time linear array high-frequency probe with GE E9 ultrasonic instrument was used, the frequency of probe was 6-15MHz. First, routine ultrasonography (including 2-D, color Doppler, spectrum Doppler) was performed to observe the internal echo, posterior echo, shape, boundary, measurement size, aspect ratio, blood supply and resistance index of blood flow (RI.). Then the elastic imaging program was started, the real-time double-amplitude mode was used, the elastic imaging was diagnosed by the scoring method, and the semi-quantitative diagnosis of the lesion was carried out with BI-RADS-US classification method at the same time. Mammography: the mammography instrument for mammography was GEApha ST MGF- 101 mammography. Axial and oblique mammography of both sides of the breast were used in the mammography of both sides of the patients, and the mammography of both sides of the breast was performed on both sides of the breast with axial and oblique projection. In some cases, lateral radiographs or local radiographs were transformed into digital images and processed. Results: 1. The sensitivity and specificity of ultrasonic elastography and BI-RADS-US classification were 84.44% and 89.02%, respectively. After analysis by 蠂 2 test, the sensitivity and specificity were 84.44% and 89.02%, respectively (蠂 2 = 67.274, P < 0.000), and the sensitivity and specificity were 84.44% and 89.02%, respectively. The results were statistically significant. 2. In combination with benign and malignant tumors, the area ratio (t = 5.694, P = 0.001) was also statistically significant in the evaluation of diagnostic grading images and two-dimensional images (t = 5.694, P < 0.001). 3. The coincidence rate of ultrasonic elastography and BI-RADS-US classification in the diagnosis of breast space occupying lesions was higher than that of mammography. Conclusion: the combined use of ultrasonic elastic imaging score and BI-RADS-US classification can help the diagnosis of benign and malignant breast masses in elderly patients and improve the accuracy of diagnosis of breast masses.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.9;R445.1
本文編號(hào)：2448602
[Abstract]:Objective: to discuss the value of combined ultrasonic elastography and BI-RADS-US classification in the diagnosis of breast cancer. Methods: from January 2012 to April 2014, 93 elderly patients with breast space occupying lesions were selected as the subjects. The average age of the patients was (68.46 鹵11.51) years old, and the mean age of the patients was (68.46 鹵11.51) years old, and the average age of the patients was (68.46 鹵11.51) years old. All patients had final surgical or puncture results. All the patients in the group were diagnosed by ultrasonic elastography and BI-RADS-US classification. The breast aluminum target examination was used as the control group, and the diagnosis results were compared by pathology. Methods: the patients were taken from normal supine position and exposed to both breast and armpit. The real-time linear array high-frequency probe with GE E9 ultrasonic instrument was used, the frequency of probe was 6-15MHz. First, routine ultrasonography (including 2-D, color Doppler, spectrum Doppler) was performed to observe the internal echo, posterior echo, shape, boundary, measurement size, aspect ratio, blood supply and resistance index of blood flow (RI.). Then the elastic imaging program was started, the real-time double-amplitude mode was used, the elastic imaging was diagnosed by the scoring method, and the semi-quantitative diagnosis of the lesion was carried out with BI-RADS-US classification method at the same time. Mammography: the mammography instrument for mammography was GEApha ST MGF- 101 mammography. Axial and oblique mammography of both sides of the breast were used in the mammography of both sides of the patients, and the mammography of both sides of the breast was performed on both sides of the breast with axial and oblique projection. In some cases, lateral radiographs or local radiographs were transformed into digital images and processed. Results: 1. The sensitivity and specificity of ultrasonic elastography and BI-RADS-US classification were 84.44% and 89.02%, respectively. After analysis by 蠂 2 test, the sensitivity and specificity were 84.44% and 89.02%, respectively (蠂 2 = 67.274, P < 0.000), and the sensitivity and specificity were 84.44% and 89.02%, respectively. The results were statistically significant. 2. In combination with benign and malignant tumors, the area ratio (t = 5.694, P = 0.001) was also statistically significant in the evaluation of diagnostic grading images and two-dimensional images (t = 5.694, P < 0.001). 3. The coincidence rate of ultrasonic elastography and BI-RADS-US classification in the diagnosis of breast space occupying lesions was higher than that of mammography. Conclusion: the combined use of ultrasonic elastic imaging score and BI-RADS-US classification can help the diagnosis of benign and malignant breast masses in elderly patients and improve the accuracy of diagnosis of breast masses.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.9;R445.1
【共引文獻(xiàn)】
相關(guān)期刊論文 前1條
1 郭曉靜;曹妮達(dá);陶麗;鄭堅(jiān);;晚期結(jié)直腸癌二線治療研究進(jìn)展[J];中華臨床醫(yī)師雜志(電子版);2015年07期
相關(guān)碩士學(xué)位論文 前2條
1 呂利紅;仙居縣內(nèi)鏡下碘染色食管/賁門癌篩查及食管異型增生隨訪[D];浙江大學(xué);2014年
2 潘虹;射頻消融治療59例結(jié)直腸癌肝轉(zhuǎn)移的回顧性研究[D];浙江大學(xué);2014年
，本文編號(hào)：2448602
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