X線滾動位結合點壓放大攝影對乳腺疾病診斷的應用研究
本文選題:全數字化乳腺X線攝影 + 點壓放大; 參考:《內蒙古大學》2017年碩士論文
【摘要】:X線檢查是乳腺疾病篩查及診斷的首選檢查方法,多種投照體位相結合在乳腺X線檢查可以提高診斷的敏感性及特異性。目的:探討局部點壓+滾動位攝影技術相結合對乳腺疾病診斷的作用。方法:選取共計125例行乳腺X線常規(guī)檢查+局部點壓放大+滾動位并經病理驗證患者,其中查體可觸及腫塊患者79例,不可觸及腫塊患者46例,對患者圖像進行對比性研究。結果:125例患者,其中乳腺癌66例,良性腫塊30例,非典型性增生8例,乳腺增生21例。其中79例可觸及腫塊的患者行常規(guī)乳腺X線攝影的敏感性、特異性、約登指數分別為:70.0%、48.4%、0.184。常規(guī)乳腺X線攝影+點壓放大的敏感性、特異性、約登指數分別為:84.8%、75.8%、0.606。常規(guī)乳腺X線攝影+攝點壓放大+滾動位的敏感性、特異性、約登指數分別為:95.7%、93.9%、0.896。46例不可觸及腫塊的患者行常規(guī)乳腺X線攝影的敏感性、特異性、約登指數分別為:75.0%、55.6%、0.306。常規(guī)乳腺X線攝影+攝點壓放大的敏感性、特異性、約登指數分別為:89.2%、88.9%、0.781.常規(guī)乳腺X線攝影+攝點壓放大+滾動位的敏感性、特異性、約登指數分別為:92.9%、94.4%、0.873。針對79例查體可觸及疑似腫塊患者,常規(guī)攝影+點壓放大攝影+滾動位,其靈敏性及特異性明顯高于常規(guī)攝影及常規(guī)攝影+點壓放大攝影,經統(tǒng)計學分析,具有統(tǒng)計學意義。46例查體不可觸及腫塊患者,常規(guī)攝影+點壓放大攝影,其靈敏性及特異性明顯高于常規(guī)攝影,經統(tǒng)計學分析,具有統(tǒng)計學意義;而同常規(guī)攝影+點壓放大攝影+滾動位差距不大,經統(tǒng)計學分析,不具有統(tǒng)計學意義。結論:常規(guī)攝影+點壓放大攝影+滾動位,對可觸及疑似腫塊的乳腺病變診斷優(yōu)于單純的常規(guī)攝影及常規(guī)攝影+點壓放大,特別是對于在單一體位上顯示的腫塊以及在診斷時對腫塊所累及的范圍有疑問時,更具有價值。而在針對不可觸及腫塊的乳腺病變時,常規(guī)攝影+點壓放大攝影+滾動位,與常規(guī)攝影+點壓放大攝影對乳腺病變診斷幫助不大,而前兩者均優(yōu)于單純的常規(guī)攝影。點壓放大攝影對于不可觸及的乳腺病變,特別是對微小鈣化的性質的評估具有重要的價值,而滾動位在行點壓放大攝影后對此類病變的價值相對較小。
[Abstract]:X-ray examination is the first choice for screening and diagnosis of breast diseases. The combination of multiple radiographic posture and mammography can improve the sensitivity and specificity of the diagnosis.Objective: to explore the role of local point pressure rolling-position photography in the diagnosis of breast diseases.Methods: a total of 125 patients were examined by routine mammography, including 79 patients with mass and 46 patients with untouchable mass. The image of the patients was compared.Results among 125 cases, 66 cases were breast cancer, 30 cases were benign mass, 8 cases were atypical hyperplasia, 21 cases were hyperplasia of mammary gland.The sensitivity and specificity of conventional mammography in 79 patients with palpable masses were 0.184, respectively.In conventional mammography, the sensitivity and specificity of dot pressure amplification were 75.80.606 and 0.606, respectively.The sensitivity and specificity of conventional mammography in magnifying the rolling position were 93.9 and 0.896.46, respectively. The sensitivity and specificity of conventional mammography were: 1 / 75.0 / 55.6and 0.306respectively.In conventional mammography, the sensitivity and specificity of point pressure amplification were 88.9% and 0.781respectively.In conventional mammography, the sensitivity and specificity of the point pressure amplification of the rolling position were 94.4% and 0.873, respectively.For 79 patients with suspected mass, the sensitivity and specificity of conventional point pressure amplification were significantly higher than that of conventional and conventional point pressure amplification.The sensitivity and specificity of conventional point pressure amplification photography were significantly higher than that of conventional photography.However, there is not significant difference between point pressure magnification and rolling position of conventional photography, which is not statistically significant by statistical analysis.Conclusion: the diagnosis of breast lesions with conventional point pressure magnification is superior to that of conventional radiography and conventional radiography in the diagnosis of breast lesions which can reach the suspected masses.Especially, it is more valuable to show the mass on the single body position and to question the extent of the mass involved in the diagnosis.In the case of untouchable breast lesions, the point pressure magnification of conventional photography is of little help to the diagnosis of breast lesions, and the former is better than that of simple conventional photography.Point-pressure magnification is of great value for the assessment of the nature of unreachable breast lesions, especially for micro-calcification, but the rolling position is of relatively little value to such lesions after point pressure amplification.
【學位授予單位】:內蒙古大學
【學位級別】:碩士
【學位授予年份】:2017
【分類號】:R816.4;R655.8
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