摘要
目的评价经皮超声造影鉴别肿瘤转移性和炎性腋窝淋巴结的价值。资料与方法临床高度疑似原发性乳腺癌或乳腺炎的40例患者,乳房内均可触及肿块并伴有腋窝淋巴结增大,常规超声观察腋窝淋巴结的大小、纵横比及回声特点;然后在肿块周边皮下注入超声造影剂SonoVue,采用超声造影成像观察同侧腋窝淋巴结的位置及增强情况,记录腋窝淋巴结的开始增强时间及增强特点;根据病理结果比较乳腺癌和乳腺炎引起的腋窝淋巴结造影情况。结果 40例患者共检测到41枚前哨淋巴结(SLN),其中13例检出的19枚SLN表现为快速、均匀的高增强,病理检查证实为淋巴结内炎症细胞浸润;其余27例患者中,5例SLN未显示,22例淋巴结内均可见不同程度的灌注缺损区,缺损区始终不增强,病理检查证实淋巴结内见癌转移,两组差异有统计学意义(P<0.001);乳腺癌组SLN开始显影时间为(8.27±2.19)min,明显长于乳腺炎组的(2.46±0.42)min,差异有统计学意义(P<0.05)。肿瘤转移性淋巴结纵横比多小于2,而炎性淋巴结纵横比多大于2,两组差异有统计学意义(P<0.01)。结论乳腺肿块周围皮下注射SonoVue可以使SLN成像,经皮淋巴超声造影对鉴别诊断肿瘤转移性和炎性增大的腋窝淋巴结有重要价值。
Purpose To evaluate the value of percutaneous contrast-enhanced ultrasonography lbr the differentiation of axillary lymphadenovarix caused by tumor metastasis and inflammation. Materials and Methods Forty patients highly suspected as primary breast cancer or mastitis were enrolled, palpable mass of the breast and axillary lymph nodes was detected through palpation in each patient, routine ultrasound was applied to observe the size, aspect ratio, and echo characteristics of the axillary lymph nodes were recorded; then ultrasound contrast agent SonoVue was injected subcutaneously around the tumor, the position and enhanced situation of the ipsilateral axillary lymph nodes was observed using contrast-enhanced ultrasonography, enhancement-starting time and enhanced features of the axillary lymph nodes were recorded. Features of contrast- enhanced ultrasonography of axillary lymph nodes caused by breast cancer and mastitis were compared according to the pathological results, Results Forty-one sentinel lymph nodes （SLN） were detected in 40 patients, of which 19 SLN detected in 13 patients appeared as fast, uniform high enhancement, which was confirmed by pathology as infiltration of inflammatory cells within the lymph node. Among the remaining 27 patients, SLN was absent in five cases, varying degrees of perfusion defect within the lymph nodes were observed in 22 cases, and the defect consistently remained unenhanced, pathological examination confirmed that lymph node metastases were seen within the lymph nodes, and there was statistically significant difference between the two groups （P〈0.001）; enhancenaent-starting time of SLN in breast cancer group was （8.27 ±2.19） rain, which was significantly longer than （2.46±0.42） rain of the mastitis group with statistical ditt^rence （P〈O.05）. The aspect ratio of most tumor metastatic lymph node was less than 2, while that of the inflammatory lymph node was larger than 2, with statistical difference between the two groups （P〈0.01）. Conclusion Sentinel lymph node imaging can be made through subcutaneous injection of SonoVue surrounding breast lumps, percutaneous contrast-enhanced ultrasonography is significantly ilaaportant lbr the differential diagnosis of axillary lymphadenovarix caused by lymphatic metastasis and inflammation.
出处
《中国医学影像学杂志》
CSCD
北大核心
2013年第9期662-665,共4页
Chinese Journal of Medical Imaging
基金
南充市科技局项目(11A0103)
关键词
乳腺肿瘤
乳腺炎
超声检查
乳房
造影剂
淋巴结
诊断
鉴别
Breast neoplasms
Mastitis
Ultrasonography, mammary
Contrast media
Lymph nodes
Diagnosis, differential
作者简介
通讯作者 刘健 E—mail：liujiansh@126．com
