本文選題：聲輻射力脈沖 + 彈性成像　； 參考：《南昌大學》2017年碩士論文

【摘要】：目的:1.通過觀察干燥綜合征(SS)患者唾液腺常規(guī)超聲特征,探討超聲評分對SS的診斷的價值。2.運用聲輻射力脈沖(ARFI)技術測量SS患者唾液腺硬度,探討ARFI成像對SS的診斷價值。方法:收集我院風濕免疫科門診或住院的SS疑診的患者者155例,將患者分為SS組76例和非SS組79例。對所有患者雙側腮腺及頜下腺進行二維超聲檢查,獲得雙側腮腺及頜下腺的聲像圖表現(xiàn),采用半定量評分方法對其進行評分。隨后對雙側腮腺及頜下腺進行ARFI檢查,獲得雙側腮腺及頜下腺的剪切波速度(SWV)。比較兩組間唾液腺超聲評分及SWV值的差異性并分析其診斷SS的價值。結果:1、非SS組中唾液腺超聲64例(64/79,81.0%)表現(xiàn)為正常,評為0分,而SS組64例(64/76,84.2%)唾液腺超聲評分≥1分。SS組唾液腺超聲評分高于非SS組(P0.001)。2、唾液腺超聲評分診斷SS的ROC曲線下面積為0.883(95%置信區(qū)間0.826,0.940),以2分為臨界值診斷SS靈敏度為73.7%,特異度為94.9%,準確率為84.5%。3、SS組及非SS組同組內雙側腮腺、頜下腺間SWV值差異均無統(tǒng)計學意義(P0.05);不同組間腮腺及頜下腺SWV值差異均有統(tǒng)計學意義(P0.05)4、頜下腺ARFI診斷SS的ROC曲線下面積為0.859(95%置信區(qū)間0.767,0.950),以2.14m/s為臨界值診斷SS靈敏度為76.3%,特異度為84.6%。腮腺ARFI診斷SS的ROC曲線下面積為0.843(95%置信區(qū)間0.741,0.945),以1.98m/s為臨界值診斷SS靈敏度為84.2%,特異度為84.6%。唾液腺ARFI成像診斷SS的最佳截斷值、敏感性、特異性、準確率及ROC曲線下面積分別為2.11 m/s、81.6%、88.5%、85.2%及0.890。5、唾液腺超聲評分聯(lián)合ARFI成像診斷SS的敏感性、特異性及準確率分別為95.2%、84.0%、89.0%。結論:唾液腺超聲評分法可為唾液腺回聲的均勻程度提供半定量指標,輔助SS的診斷具有較高的特異度。ARFI成像可以提供唾液腺SWV值,定量反應唾液腺彈性,SS患者的腮腺及頜下腺的硬度高于非SS患者,在SS診斷中具有重要價值。唾液腺常規(guī)超聲聯(lián)合ARFI成像對SS的診斷價值與單一成像相當。
[Abstract]:Purpose 1.By observing the characteristics of salivary gland routine ultrasound in patients with Sjogren's syndrome (SS), the value of ultrasonic score in the diagnosis of SS was discussed.The salivary gland hardness of SS patients was measured by acoustic radiation power pulse technique (ARFI), and the diagnostic value of ARFI imaging for SS was discussed.Methods: 155 patients with suspected SS were divided into SS group (n = 76) and non-SS group (n = 79).Two-dimensional ultrasonography was performed on the bilateral parotid and submandibular glands of all patients, and the sonographic features of the bilateral parotid and submandibular glands were obtained and scored by semi-quantitative scoring method.The shear wave velocities of bilateral parotid and submandibular glands were obtained by ARFI.The differences of salivary gland ultrasound score and SWV between the two groups were compared and the diagnostic value of SS was analyzed.Results in the non-SS group, 64 cases of salivary gland ultrasound showed normal results (64 / 79 / 81.0), with a score of 0.The salivary gland ultrasound score of SS group was higher than that of non-SS group (P 0.001). The area under the ROC curve of SS was 0.88395% confidence interval 0.8260.9400.The critical value of SS was 73.7%.The specificity was 94. 9 and the accuracy was 84. 5%. The parotid glands in the same group and non-SS group were 84.5% and 84. 5% respectively.There was no significant difference in SWV value between submandibular glands (P 0.05), and there were significant differences in SWV value of parotid gland and submandibular gland between different groups (P 0.05). The area under ROC curve of ARFI diagnosis of SS in submandibular gland was 0.859% 95% confidence interval 0.7670.95% confidence interval 0.7670.500.The critical value of 2.14m/s was sensitive to diagnose SS.The degree was 76. 3 and the specificity was 84. 6.The area under the ROC curve of parotid gland ARFI diagnosis SS was 0.843 ~ 95% confidence interval 0.741 ~ 0.945%. The sensitivity and specificity of 1.98m/s were 84.2% and 84.6% respectively.The best truncation value, sensitivity, specificity, accuracy and area under the ROC curve of salivary gland ARFI were 2.11 m / s 81.6% and 0.890.5%, respectively. The sensitivity, specificity and accuracy of salivary gland ultrasound score combined with ARFI imaging in the diagnosis of SS were 95.2or 84.0 and 89.0, respectively.Conclusion: the salivary gland ultrasound scoring method can provide a semi-quantitative index for the homogeneity of salivary gland echo. The diagnostic specificity of the adjuvant SS is higher. ARFI imaging can provide the salivary gland SWV value.The hardness of parotid gland and submandibular gland in patients with quantitative response to salivary gland elasticity was higher than that in non-SS patients, which was of great value in the diagnosis of SS.The diagnostic value of salivary gland conventional ultrasound combined with ARFI imaging in SS is similar to that of single imaging.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R445.1;R593.2

【參考文獻】

相關期刊論文 前10條

1 陳紹琦;王育凱;伍秋林;何結儀;;聲輻射力脈沖彈性成像技術診斷早期干燥綜合征涎腺病變的價值[J];中華醫(yī)學超聲雜志(電子版);2016年04期

2 王瑋玖;李士星;張歆穎;;干燥綜合征超聲檢查回顧性分析[J];生物醫(yī)學工程與臨床;2015年04期

3 金亞;彭玉蘭;趙海娜;史巖;何玉霜;;正常成人腮腺和頜下腺實時剪切波彈性成像的初步研究[J];華西醫(yī)學;2015年04期

4 韋潔勤;張靜;陸力堅;李偉雄;;干燥綜合征腮腺導管MRS與CT及X線造影對比研究[J];中國臨床新醫(yī)學;2015年03期

5 杜啟亙;蘇雁欣;;超聲彈性成像技術鑒別診斷腮腺腫瘤[J];中國醫(yī)學影像技術;2015年03期

6 楊銀廣;楊仁東;陳麗珍;黃楨;;原發(fā)性干燥綜合征的涎腺超聲表現(xiàn)及其在診斷中的價值[J];中國臨床研究;2015年02期

7 王健楠;王學梅;歐國成;;超聲彈性成像在干燥綜合征診斷中的應用價值[J];中國超聲醫(yī)學雜志;2013年01期

8 徐鐘慧;王鴻琳;杜德順;李建初;姜玉新;戴晴;;多普勒超聲觀察干燥綜合征腮腺病變的血流動力學特征[J];中國醫(yī)學影像技術;2010年09期

9 徐鐘慧;王鴻琳;杜德順;李建初;姜玉新;戴晴;;超聲診斷干燥綜合征腮腺病變[J];中國醫(yī)學影像技術;2009年03期

10 蘇一巾,杜聯(lián)芳,史莉玲;干燥綜合征腮腺超聲與X線造影的對比研究[J];中華超聲影像學雜志;2004年08期

相關碩士學位論文 前2條

1 黃英;干燥綜合征腮腺超聲與磁共振導管成像的對比研究[D];廣西醫(yī)科大學;2015年

2 王月霞;干燥綜合征臨床研究[D];大連醫(yī)科大學;2013年

，

本文編號：1748930