本文選題：超聲組織彈性成像 + 乳腺腫塊��； 參考：《吉林大學》2014年碩士論文

【摘要】：目的： 通過測定乳腺腫塊的二維超聲（Two-dimensional Ultrasound）及超聲組織彈性成像（Ultrasonicelastography，UE）參數，分析研究超聲組織彈性成像（Ultrasonic elastography，UE）技術對乳腺腫塊良惡性的診斷價值。 資料與方法： 選取我院乳腺外科2012年3月至2013年6月收治的76例就診女患者為基礎研究對象。所有入組對象均經病理證實，，76例患者中共106個乳腺腫塊。研究對象中乳腺腫塊最大直徑均不足5.0cm，術前未接受任何化療與放療，均經常規(guī)二維超聲（2D-US）進行檢查，并切換到超聲彈性成像模式，操作時將感興趣區(qū)調節(jié)到大致腫塊面積2倍左右，根據顯示屏上的質量指數（QF），以QF＞50-75為圖像質量可信的標準進行檢查。術后均經病理結果對照。所得檢測結果均進行3次重復檢查、應用彩色多普勒血流成像（CDFI）、德國西門子公司的Acuson S2000超聲診斷儀彈性成像檢查并取腫瘤直徑平均數進行統(tǒng)計，對所得乳腺腫塊間數據進行統(tǒng)計學分析，采用X2檢驗，經SPSS14.0軟件進行分析，結果以p＜0.05表示差異有統(tǒng)計學意義。 結果 1106個乳腺腫塊組織病理學金標準診斷結果：79個良性腫塊，27個惡性腫塊。 2常規(guī)二維超聲診斷乳腺腫塊良惡性的靈敏性為81.48%（22/27）、特異性68.35（%54/79）、準確性71.70%（76/106）、陽性預測值91.53%（54/59）、陰性預測值46.81%（22/47）。 3UE評分診斷79個良性病灶中，3級以下62個78.48%（62/79），4級以上17個21.52%（17/79）；27個惡性病灶中，3級以下5個18.52%（5/27），4級以上22個81.48%（22/27）。 4常規(guī)二維超聲與UE聯(lián)合診斷靈敏性92.59%（25/27）、特異性94.94%（75/79）、準確性96.23%（102/106）、陽性預測值97.40%（75/77）、陰性預測值86.21%（25/29）。 結論： 1常規(guī)二維超聲診斷、超聲組織彈性成像評分、常規(guī)二維超聲診斷聯(lián)合超聲組織彈性成像評分這三種方法對乳腺腫塊良惡性的診斷均具有一定臨床價值，但是單純應用其中一種方法進行診斷乳腺腫塊良惡性與敏感性之間差異無明顯統(tǒng)計學意義（p＞0.05）。 2聯(lián)合診斷對乳腺腫塊良惡性的敏感性、準確性、特異性均顯著高于單獨應用2D及UE診斷結果。 3三種方法陽性預測值間有統(tǒng)計學意義（p＜0.05），但陰性預測值間無統(tǒng)計學意義（p＞0.05）。 4雖然超聲組織彈性成像技術聯(lián)合診斷方法在評定乳腺癌中有一定差異，但是其在診斷乳腺腫塊的良惡性方面上價值是不可置疑的。
[Abstract]:Objective: By measuring the parameters of Two-dimensional Ultrasound and Ultrasound elastography in breast masses, the diagnostic value of ultrasonic elastography and ultrasonic elastography in diagnosis of breast masses was studied. Information and methods: From March 2012 to June 2013, 76 female patients in our department of breast surgery were selected as basic research objects. A total of 106 breast masses were confirmed by pathology in 76 patients. The maximum diameters of breast masses were less than 5.0 cm. No chemotherapy and radiotherapy were performed before the study. They were examined by conventional two-dimensional ultrasonography (2D-USS) and switched to the mode of ultrasound elastic imaging. During operation, the area of interest was adjusted to about 2 times of the area of the mass. According to the quality index on the display screen, QF > 50-75 was used as the reliable standard of image quality. Postoperative pathological results were compared. The results were all repeated three times. The color Doppler flow imaging (CDFI) and the Acuson S2000 ultrasonic diagnostic instrument of Siemens Company of Germany were used to examine the results of elastic imaging, and the mean diameter of the tumor was calculated. The data of breast masses were statistically analyzed by X2 test and analyzed by SPSS14.0 software. The results showed that the difference was statistically significant with p < 0. 05. Result The diagnostic results of 1106 breast masses were as follows: 79 benign masses and 27 malignant masses. 2the sensitivity of conventional two-dimensional ultrasound in the diagnosis of benign and malignant breast masses was 81.48 and 22 / 27, the specificity was 68.35 / T / 79, the accuracy was 71.70 / 106, the positive predictive value was 91.53 / 59 and the negative predictive value was 46.81 / 47. Of the 79 benign lesions diagnosed by 3UE score, 62 were below 78.48 and 17 were above 62 / 79 / 4, 17 / 21.52 / 79 / 79, and 5 of 27 malignant lesions were below grade 3 and 5 18. 52 / 27 / 4, 22 / 81.48 were 22 / 27 / 27. (4) the sensitivity of conventional two-dimensional ultrasound combined with UE is 92.599.25 / 27, the specificity is 94.94 and 75 / 79, the accuracy is 96.23 / 102 / 106, the positive predictive value is 97.40 / 77 and the negative predictive value is 86.21 / 25 / 29. Conclusion: 1 the three methods of conventional two-dimensional ultrasound diagnosis, ultrasonic tissue elastic imaging score and conventional two-dimensional ultrasound diagnosis combined with ultrasound tissue elastic imaging score have certain clinical value in the diagnosis of breast masses. However, there was no significant difference in sensitivity between benign and malignant breast masses by using one of the methods alone (P > 0.05). 2 the sensitivity, accuracy and specificity of combined diagnosis for benign and malignant breast masses were significantly higher than those for 2D and UE alone. 3There was significant difference between the positive predictive values of the three methods (p < 0.05), but there was no significant difference between the negative predictive values and the positive predictive values (P > 0.05). 4 although there are some differences in the diagnosis of breast cancer with ultrasonic tissue elastography, its value in the diagnosis of benign and malignant breast masses is indisputable.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R737.9;R445.1

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