三維增強(qiáng)乳腺斷層攝影及全數(shù)字化平板乳腺檢查對(duì)乳腺微小簇狀鈣化診斷的對(duì)比研究
發(fā)布時(shí)間:2018-03-19 15:43
本文選題:乳腺微小簇狀鈣化灶 切入點(diǎn):三維增強(qiáng)斷層乳腺攝影 出處:《山西醫(yī)科大學(xué)》2014年碩士論文 論文類型:學(xué)位論文
【摘要】:研究背景:乳腺X線檢查目前被公認(rèn)為是乳腺癌的首選檢查方式,特別對(duì)早期乳腺癌的診斷更具優(yōu)勢(shì)。標(biāo)準(zhǔn)化2D乳房X線造影術(shù)受限于乳腺組織重疊,容易受到隱藏癌癥病灶的干擾或?qū)⒄=M織視為異常。近年來(lái)影像設(shè)備不斷更新,三維增強(qiáng)乳腺斷層攝影(Digital breast tomosynthesis,DBT)的出現(xiàn),使乳腺癌病變X線征象顯示清晰度有了明顯的提高,臨床診治早期乳腺癌所占比例明顯增大。三維增強(qiáng)乳腺斷層攝影(DBT)能夠克服全數(shù)字化乳腺攝影(FFDM)因組織重疊而影響病變觀察的問題,,降低復(fù)檢率,減少不必要的活檢,提高癌灶的檢出率。對(duì)于致密型乳腺,DBT可以減少“假陽(yáng)性”的檢出。 目的:通過(guò)比較三維增強(qiáng)斷層乳腺鉬靶與全數(shù)字化平板乳腺檢查這兩種方法在乳腺微小簇狀鈣化診斷中診斷結(jié)果陽(yáng)性率、平均閱片時(shí)間和定位準(zhǔn)確性方面的差異,為臨床提供更優(yōu)化的檢查手段,以期提高乳腺微小簇狀鈣化診斷水平。方法:選取80例2012年9月至2013年12月期間山西省腫瘤醫(yī)院乳腺科超聲檢查為陰性的住院患者,BIRADS Ⅳ級(jí)、體格檢查陰性的住院病例,各40例,隨機(jī)進(jìn)行三維增強(qiáng)斷層乳腺攝影(A組)與全數(shù)字化平板乳腺機(jī)鉬靶X線檢查(B組),診斷乳腺微小簇狀鈣化,使用巴德雙鉤定位針鉬靶輔助下行乳腺微小簇狀鈣化定位并行手術(shù)治療。采用SPSS13.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析,評(píng)價(jià)兩組在初始閱片時(shí)間、穿刺定位后病理診斷結(jié)果(陽(yáng)性率)以及定位時(shí)的照射次數(shù)的差異。 結(jié)果:與全數(shù)字化平板乳腺機(jī)檢查組比較,三維增強(qiáng)斷層乳腺攝影檢查組在診斷結(jié)果陽(yáng)性率,平均閱片時(shí)間和定位時(shí)的照射次數(shù)方面的均存在顯著性差異(P0.05),差異具有統(tǒng)計(jì)學(xué)意義。 結(jié)論:與全數(shù)字化平板乳腺檢查比較,三維增強(qiáng)斷層乳腺鉬靶檢查具有更高的診斷陽(yáng)性率,且閱片時(shí)間更短,定位更準(zhǔn)確,可以有效減低乳腺癌診斷的誤診率及漏診率,建議可疑乳腺癌患者行三維增強(qiáng)斷層鉬靶檢查或復(fù)查。
[Abstract]:Background: mammography is currently recognized as the preferred method for breast cancer, especially for the diagnosis of early breast cancer. Standardized 2D mammography is limited to overlapping breast tissue. It is easy to be disturbed by hidden cancer lesions or to regard normal tissue as abnormal. In recent years, the imaging equipment has been continuously updated, and the appearance of 3D enhanced mammography Digital breast tomosynthesisDBT (DBT) has significantly improved the clarity of X-ray signs of breast cancer. The proportion of clinical diagnosis and treatment of early breast cancer is obviously increased. Three-dimensional enhanced mammography (DBT) can overcome the problem that the tissue overlap of all digital mammography (FFDM) affects the observation of pathological changes, reduce the rate of re-examination and reduce the unnecessary biopsy. To improve the detection rate of breast cancer, DBT can reduce the false positive rate. Objective: to compare the difference between three dimensional enhanced tomography mammography and all digital flat mammary gland examination in the diagnosis of small cluster calcification of mammary gland, such as the positive rate of diagnosis, the average reading time and the accuracy of localization. In order to improve the diagnostic level of breast microcluster calcification, 80 patients with negative breast ultrasound examination from September 2012 to December 2013 in Shanxi Cancer Hospital were selected as BIRADS 鈪
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