本文關(guān)鍵詞： 彈性成像技術(shù) 乳腺疾病 超聲檢查 平均光密度 BI-RADS分級(jí)　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的應(yīng)用聲脈沖輻射力成像(ARFI)技術(shù)觀察乳腺病灶組織軟硬度,定量分析聲脈沖輻射力成像技術(shù)對(duì)乳腺影像報(bào)告和數(shù)據(jù)系統(tǒng)(BI-RADS)的價(jià)值,期待早期發(fā)現(xiàn)乳腺惡性病灶患者,提高患者的生存率及生活質(zhì)量。資料與方法收集經(jīng)穿刺細(xì)胞學(xué)檢查及手術(shù)病理結(jié)果確診的175例患者共179個(gè)乳腺病灶,均進(jìn)行常規(guī)超聲、聲觸診組織量化(VTQ)檢查、聲觸診組織成像(VTI)檢查,得出病灶的剪切波速度值(SWV)及通過(guò)使用Image J軟件分析VTI圖像計(jì)算得出的平均光密度值,并將乳腺病灶的常規(guī)超聲圖像進(jìn)行BI-RADS分級(jí)。通過(guò)統(tǒng)計(jì)方法比較常規(guī)超聲BI-RADS分級(jí)、VTQ檢查、VTI檢查及三者聯(lián)合方法在乳腺病灶診斷中的差異,分析聲脈沖輻射力成像在BI-RADS分級(jí)中的意義。結(jié)果1.經(jīng)過(guò)病理證實(shí),179個(gè)乳腺病灶中惡性病灶71個(gè)、良性病灶108個(gè)。繪制ROC曲線,VTQ檢查得出剪切波速度值的ROC曲線下面積(AUC)為0.883,分析得出判斷良惡性乳腺病灶的界值為3.54m/s;VTI檢查得出平均光密度值的曲線下面積為0.933,所對(duì)應(yīng)的界值為202.25。惡性乳腺病灶VTQ值≥3.54m/s個(gè)數(shù)為55,3.54 m/s個(gè)數(shù)為16,良性乳腺病灶VTQ值≥3.54 m/s個(gè)數(shù)為7,3.54m/s個(gè)數(shù)為101(t=11.227,P=0.000)。惡性乳腺病灶的平均光密度值≥202.25的個(gè)數(shù)為66,202.25的個(gè)數(shù)為5,良性乳腺病灶的平均光密度值≥202.25的個(gè)數(shù)為10,202.25的個(gè)數(shù)為98(t=12.364,P=0.000)。常規(guī)超聲BI-RADS分級(jí)在診斷乳腺良惡性病灶的敏感度97.18%(69/71)、特異度42.59%(46/108)、陽(yáng)性預(yù)測(cè)值52.67%(69/131)、陰性預(yù)測(cè)值95.83%(46/48)、準(zhǔn)確率64.25%(115/179),約登指數(shù)0.3977;三者聯(lián)合方法在診斷乳腺病灶的敏感度94.37%(67/71)、特異度88.89%(96/108)、陽(yáng)性預(yù)測(cè)值84.81%(67/79)、陰性預(yù)測(cè)值96%(96/100)、準(zhǔn)確率91.06%(163/179)及約登指數(shù)0.8326。2.VTQ檢查與常規(guī)超聲BI-RADS分級(jí)比較:常規(guī)超聲BI-RADS分級(jí)靈敏度高于VTQ檢查(P=0.001),VTQ檢查特異度、陽(yáng)性預(yù)測(cè)值、準(zhǔn)確率高于常規(guī)超聲BI-RADS分級(jí)(P=0.000),以特異度指標(biāo)更好。3.VTQ檢查與三者聯(lián)合方法比較:聯(lián)合方法靈敏度高于VTQ檢查(P=0.004)。4.VTI檢查與常規(guī)超聲BI-RADS分級(jí)比較:VTI檢查特異度、陽(yáng)性預(yù)測(cè)值、準(zhǔn)確率高于常規(guī)超聲BI-RADS分級(jí)(P=0.000),以特異度指標(biāo)更好。5.三者聯(lián)合方法與常規(guī)超聲BI-RADS分級(jí)比較:聯(lián)合方法特異度、陽(yáng)性預(yù)測(cè)值、準(zhǔn)確率高于常規(guī)超聲BI-RADS分級(jí)(P=0.000),以特異度指標(biāo)更好。結(jié)論1.聲脈沖輻射力成像的兩種方法VTQ檢查與VTI檢查在診斷乳腺良惡性病灶中具有重要意義。2.VTQ檢查與VTI檢查比較,在診斷乳腺良惡性病灶上各參數(shù)指標(biāo)無(wú)明顯差異。3.聲脈沖輻射力成像能彌補(bǔ)常規(guī)超聲的不足,早期發(fā)現(xiàn)惡性小病灶,較準(zhǔn)確判斷乳腺良惡性病灶,提高了診斷準(zhǔn)確率。
[Abstract]:Objective to observe the soft and hard degree of breast lesions by acoustic pulse radiation force imaging (ARFI). Quantitative analysis of the value of acoustic pulse radiography in breast imaging reporting and data system BI-RADS, looking forward to early detection of breast malignant lesions in patients. Data and methods 175 patients with 179 breast lesions confirmed by puncture cytology and surgical and pathological results were examined by conventional ultrasound. Acoustic palpation tissue quantification (VTQ) and acoustic palpation tissue imaging (VTI) were examined. The shear wave velocity (SWV) of the lesion was obtained and the average optical density was calculated by using Image J software to analyze the VTI images. The conventional ultrasound images of breast lesions were graded by BI-RADS. The conventional ultrasound BI-RADS grading was compared with VTQ by statistical method. The difference of VTI examination and combination of three methods in the diagnosis of breast lesions was analyzed. The significance of acoustic pulse radiography in BI-RADS grading was analyzed. Results 1.The results were confirmed by pathology. There were 71 malignant lesions and 108 benign lesions in 179 breast lesions. The area under the ROC curve of ROC curve was 0.883. The results showed that the cutoff value of benign and malignant breast lesions was 3.54 m / s; VTI showed that the area under the average optical density curve was 0.933, and the corresponding threshold value was 202.25.The number of VTQ 鈮，

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