本文選題：聲輻射力脈沖成像　切入點(diǎn)：聲觸診組織量化技術(shù)　出處：《皖南醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究的目的是評(píng)估超聲彈性成像聲輻射力脈沖(ARFI)技術(shù)誘導(dǎo)的聲觸診組織定性成像(VTI)和聲觸診組織定量技術(shù)(VTQ)對(duì)于診斷腮腺局灶性病變的價(jià)值。方法:選取我院口腔頜面外科因腮腺局灶性病變住院的59例患者,術(shù)前分別進(jìn)行常規(guī)超聲、ARFI成像,對(duì)腮腺病變的二維超聲圖像特征及血流信號(hào)特征進(jìn)行分析;對(duì)病變及周圍正常組織進(jìn)行VTI檢查,獲得黑白灰階圖像,采用VTI六級(jí)評(píng)分法;對(duì)病灶行VTQ檢查記錄剪切波速度(SWV)。繪制VTI分級(jí)、SWV的受試者操作特性曲線(ROC),找出VTI、VTQ診斷腮腺局灶性病變的最佳臨界值。以術(shù)后病理結(jié)果為金標(biāo)準(zhǔn),比較常規(guī)超聲、VTI、VTQ對(duì)腮腺局灶性病變的鑒別診斷價(jià)值。結(jié)果:以腮腺術(shù)后病理結(jié)果為金標(biāo)準(zhǔn),59個(gè)腮腺病變中45個(gè)為良性,14個(gè)為惡性。(1)常規(guī)超聲的聲像圖特征:形狀、邊緣、病變組成、回聲結(jié)構(gòu)、回聲反射性、有無鈣化、后方回聲增強(qiáng)及血流情況在良、惡性病變中差異無統(tǒng)計(jì)學(xué)意義;(2)VTI的ROC曲線下面積為0.813,VTI診斷腮腺局灶性病變的敏感度、特異度、準(zhǔn)確度分別為78.6%、82.2%、81.4%;(3)VTQ的ROC曲線下面積為0.782,鑒別診斷腮腺局灶性病變的SWV值最佳臨界點(diǎn)為3.89m/s,敏感度、特異度、準(zhǔn)確度分別為64.3%、86.7%、81.4%。結(jié)論:(1)腮腺良、惡性病灶的VTI分級(jí)差異有統(tǒng)計(jì)學(xué)意義,良性病灶多在I~III級(jí),惡性病灶多在IV~VI級(jí);(2)腮腺良、惡性病灶的SWV值差異有統(tǒng)計(jì)學(xué)意義,SWV值最佳臨界點(diǎn)為3.89m/s,良、惡性病灶的SWV值存在部分重疊,多形性腺瘤與惡性病灶差異無統(tǒng)計(jì)學(xué)意義;(3)腮腺多形性腺瘤的SWV值高于腺淋巴瘤,故多形性腺瘤的硬度大于腺淋巴瘤;(4)VTI和VTQ兩種方法診斷腮腺局灶性病變無統(tǒng)計(jì)學(xué)差異。
[Abstract]:Objective: to evaluate the diagnostic value of acoustic palpation tissue qualitative imaging (VTI) and acoustic palpation tissue quantitative technique (VTQ) induced by ultrasonic elastic imaging power pulse ARFI technique in the diagnosis of focal lesions of parotid gland. Methods: to evaluate the diagnostic value of acoustic palpation tissue qualitative imaging (VTI) and acoustic palpation tissue quantitative technique (VTQs) in the diagnosis of parotid gland focal lesions. A total of 59 patients with focal parotid lesions in oral and maxillofacial surgery in our hospital were selected. The features of two-dimensional ultrasound image and blood flow signal of parotid gland lesions were analyzed before operation, and the lesions and surrounding normal tissues were examined by VTI, and black and white gray-scale images were obtained by VTI six-grade scoring method. The shear wave velocities were recorded by VTQ. The operating characteristic curve of subjects with VTI grade was drawn to find out the best critical value of VTQ for the diagnosis of focal parotid lesions. The postoperative pathological results were taken as the gold standard. The value of VTQ in differential diagnosis of focal parotid lesions was compared. Results: according to the pathological results of parotid gland operation, 45 of 59 parotid lesions were benign and 14 were malignant. There was no significant difference between benign and malignant lesions in the composition of lesions, echo structure, echo reflex, calcification, posterior echo enhancement and blood flow. The area under the ROC curve of VTI was 0.813 and the sensitivity and specificity of VTI in the diagnosis of focal parotid lesions were not significant. The area under the ROC curve of VTQ was 0.782.The best critical point of SWV value for differential diagnosis of focal parotid lesions was 3.89 mSs, the sensitivity, specificity and accuracy were 64.3ms.Conclusion there were significant differences in VTI grading between benign and malignant lesions of parotid gland and parotid gland with accuracy of 82.2and 0.782.Conclusion there is a significant difference in VTI grade between benign and malignant lesions of parotid gland, and the best critical point for differential diagnosis of parotid focal lesions is 3.89 mSs, and the sensitivity, specificity and accuracy are 64.3ms. Most benign lesions were in grade Ig III, and most of malignant lesions were in grade IV~VI. The difference of SWV in malignant lesions was statistically significant. The best critical point of SWV was 3.89 m / s. The SWV values of benign and malignant lesions were partially overlapped. The SWV value of pleomorphic adenoma was higher than that of adenomatous lymphoma, so the hardness of pleomorphic adenoma was higher than that of adenomatous adenoma and VTQ.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.1;R739.87

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 劉硯青;;中國乳腺癌發(fā)病率高增之謎[J];抗癌之窗;2015年05期

2 鄭曉娜;吳耀賢;;CT及MRI檢查方法在腮腺混合瘤診斷中的應(yīng)用價(jià)值[J];中國CT和MRI雜志;2015年01期

3 肖帆;周愛云;;超聲彈性成像的基本原理及臨床應(yīng)用現(xiàn)狀[J];實(shí)用臨床醫(yī)學(xué);2014年08期

4 葉衛(wèi)華;夏英;韓若凌;陳偉;趙娜;;聲輻射力脈沖成像技術(shù)檢測(cè)腮腺及頜下腺局灶性病變的初步研究[J];中國超聲醫(yī)學(xué)雜志;2012年10期

5 李巧珍;肖螢;徐樂天;唐寧;黃思;;超聲彈性成像技術(shù)在腮腺良惡性占位性病變鑒別診斷中的應(yīng)用價(jià)值[J];中華醫(yī)學(xué)超聲雜志(電子版);2012年09期

6 Ioan Sporea;Roxana Sirli;Simona Bota;Mihaela Vlad;Alina Popescu;Ioana Zosin;;ARFI elastography for the evaluation of diffuse thyroid gland pathology:Preliminary results[J];World Journal of Radiology;2012年04期

7 謝萍;;腮腺類實(shí)性腺淋巴瘤的超聲表現(xiàn)[J];實(shí)用醫(yī)學(xué)影像雜志;2011年06期

8 孫穎浩;我國前列腺癌的研究現(xiàn)狀[J];中華泌尿外科雜志;2004年02期

9 劉繼延;趙文峰;王淑梅;徐洪權(quán);;超聲在腮腺腫瘤診斷中的價(jià)值[J];中國超聲醫(yī)學(xué)雜志;2013年04期

，

本文編號(hào)：1639425