摘要
目的探讨超声造影在诊断乳腺癌前哨淋巴结(sentinel lymph node, SLN)转移中的应用价值及其不均匀增强模式的表现分析。方法乳腺癌患者115例,术前行SLN超声造影检查,动态观测SLN的增强模式并对其进行体表标记,以术后组织病理结果为金标准,计算超声造影预测SLN转移的灵敏度、特异度和符合率,比较不同增强模式诊断SLN转移的符合率。结果 113例患者检出SLN,检出率为98.3%,共检出155个SLN,超声造影预测SLN转移的灵敏度为91.0%,特异度为73.9%,符合率为81.3%;79个表现为不均匀增强的SLN,中心部缺损诊断SLN转移的符合率(41.2%)明显低于边缘部缺损(75.0%)和完全不均匀增强(81.6%)(P<0.05),边缘部缺损与完全不均匀增强比较差异无统计学意义(P>0.05)。结论超声造影有助于识别乳腺癌SLN转移,是一种可行的SLN检查方法,不均匀增强模式中的中心部缺损无法准确预测SLN状态。
Objective To explore the application of contrast-enhanced ultrasonography(CEUS) in the diagnosis of sentinel lymph node(SLN) metastasis of breast cancer and the features of the heterogeneous enhancement pattern. Methods Totally 115 patients with breast cancer underwent CEUS before operation to observe the enhancement pattern of SLN dynamically and mark on the body surface. Taking the postoperative histopathological result as the gold standard, the sensitivity, specificity and coincidence rate of CEUS in predicting SLN metastasis were calculated. The coincidence rate of CEUS for SLN metastasis was compared in different enhancement patterns. Results SLN was detected in 113 patients(155 sentinel lymph nodes), and the detection rate was 98.3%. The sensitivity, specificity and the coincidence rate of CEUS in diagnosing SLN metastasis were 91.0%, 73.9% and 81.3%, respectively. Seventy-nine SLNs were found heterogeneous enhancement. The coincidence rate of central defect(41.2%) was significantly lower than that of marginal defect(75.0%) and completely heterogeneous enhancement(81.6%) in the diagnosis of SLN metastasis(P<0.05), and there was no significant difference between marginal defect and completely heterogeneous enhancement(P>0.05). Conclusion Being a feasible method, CEUS helps to identify SLN metastasis of breast cancer. Central defects in heterogeneous enhancement pattern cannot accurately predict SLN status.
作者
郭晓霞
刘昱含
李潜
GUO Xiaoxia;LIU Yuhan;LI Qian(Department of Ultrasound,Henan Cancer Hospital,Cancer Hospital Affiliated to Zhengzhou University,Zhengzhou 450008,China)
出处
《中华实用诊断与治疗杂志》
2019年第4期386-388,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关计划项目(2018020505)
关键词
乳腺癌
前哨淋巴结
超声造影
breast cancer
sentinel lymph node
contrast-enhanced ultrasonography
