【作者】 姜涛；

【导师】 姚兰辉；

【作者基本信息】 新疆医科大学 ， 影像医学与核医学， 2010， 硕士

【摘要】 目的：探讨彩色多普勒超声和X线钼靶摄影检查联合应用对不同年龄、肿块大小、腺体质地乳腺肿瘤的诊断价值。方法：对173例女性乳腺肿瘤患者进行彩色多普勒超声及X线钼靶摄影检查,对不同年龄、肿块大小及腺体质地的乳腺肿瘤进行分层研究,并与病理结果进行对照分析,探讨彩色多普勒超声及X线钼靶在乳腺肿瘤分层研究中的诊断价值。结果：在年龄分层中对于<45岁组超声诊断乳腺癌的灵敏度及特异度较高；将彩色多普勒超声与X线钼靶联合后各年龄段灵敏度及特异度均较高；在肿块大小分层中对于直径<1cm组X线钼靶诊断乳腺癌的灵敏度及特异度较高；对于>2cm彩色多普勒超声诊断灵敏度及特异度较高,与X线钼靶和超声联合后诊断乳腺癌的灵敏度及特异度比较差异无统计学意义；在腺体分层中对于致密性腺体超声诊断乳腺癌的灵敏度及特异度较高,而对于导管型者X线钼靶诊断的灵敏度及特异度较高；彩色多普勒超声与X线钼靶在小于45岁组及45-55岁组中二者一致性中等(Kappa值分别为0.43、0.45)；而对大于55岁组二者诊断的一致性较低(Kappa值分别为0.33)；在肿块直径1-2cm组及大于2cm组二者诊断一致性中等(Kappa值分别为0.44、0.60),而对于肿块直径小于1cm者二者一致性较低(Kappa值分别为0.35)；而在腺体质地分组中导管型组、混合型组中二者一致性中等(Kappa值分别为0.4、0.46),而在致密型组、脂肪型组中二者的一致性较低(Kappa值分别0.39、0.33)。结论：彩色多普勒超声和X线钼靶在不同年龄段、不同肿块大小及不同腺体质地的分层研究中各有优势,同时又具有其局限性,通过分层研究能够为临床更加准确诊断乳腺癌选择合适的检查方法提供重要依据。更多还原

【Abstract】 Objective:To explore the value of color Doppler ultrasonography and molybdenum target in diagnosis of patients with breast neoplasm which different size and glandular organ texture and patients in different groups of age. Methods:There were 173 patients were examined by color Doppler ultrasonography and molybdenum target, the stratified study were done for patients with breast neoplasm, the results of color Doppler ultrasonography and molybdenum target were compared with Pathology result. The value of color Doppler ultrasonography and molybdenum target in diagnosis of breast neoplasm was explored. Result:There was higher sensitivity and specificity of color Doppler ultrasonography than that of molybdenum target in diagnosis of patients with breast cancer which the groups age of patients less than 45. The molybdenum target examine had higher sensitivity and specificity than that of color Doppler ultrasonography in diagnosis of patients with breast neoplasm which the lesion size smaller than 1.0cm, while color Doppler ultrasonography had higher sensitivity and specificity in that of lesion size bigger than 2.0cm. There was higher sensitivity and specificity of color Doppler ultrasonography than that of molybdenum target in diagnosis of patients with breast cancer which breast texture was compactability, as well as molybdenum target examine had higher sensitivity and specificity which breast texture was cast type. There was a moderate level of agreement between color Doppler ultrasonography and molybdenum target in the diagnosis of breast tumors in the agespecific of<45 grouping,45～55grouping, neoplasms size grouping of 1～2cm,>2cm and breast texture grouping of catiieter type, mixted type (Kappa=0.43,0.45,0.44,0.60,0.4,0.46). There was a low of agreement in the agespecific of>55 grouping, neoplasm size grouping of<1cm and breast texture grouping of dense type, fat type (Kappa=0.33,0.35,0.39,0.33). Conclusion:There was advantage and disadvantage of color Doppler ultrasonography and molybdenum target in diagnosis of breast cancer. With the result of stratified study, it could provid an important evidence for clinician in selecting suitable examine to diagnosis breast neoplasm.更多还原