经皮下注射超声造影剂在乳腺癌前哨淋巴结诊断中的价值

The value of ultrasound contrast agents injected subcutaneously for diagnosing sentinel lymph nodes of breast cancer

目的探讨采用经皮下注射超声造影剂声诺维（SonoVue）检测乳腺癌前哨淋巴结（SLNs）并判定其性质的可行性。方法经皮下注射SonoVue对22例乳腺癌患者进行超声造影检查，观察同侧腋窝SLNs的造影增强情况；然后经皮下注射美蓝后手术切除SLNs进行病理学检查。结果22例患者术前超声造影发现SLNs32个，其中29个超声造影对其转移与否进行了准确的判断。以手术切除为标准，超声造影对SLNs检出率为91．4％（32／35）。根据造影增强的特点判定SLNs转移与否的敏感性、特异性和准确性分别为90．9％、90．5％和91．0％。结论经皮下注射SonoVue可较好地检测出SLNs并准确地判断其转移与否，具有很高的临床应用价值。

Objective To explore the feasibility of the sentinel lymph nodes （SLNs） detection and identification after peritumoral injection of a ultrasound contrast agent. Methods The subjects were 22 women with breast cancer. Each was injected subcutaneously with 2.4ml SonoVue directly superficial to the breast tumor. The SLNs were detected and observed by contrast enhanced ultrasound（CEUS）. Then a methylene blue was followed by dissection. Results Thirty-two SLNs were detected in 22 patients and 29 SLNs were correctly assessed using CEUS before operation. Compared with dissection, the detecting rate of CEUS for SLNs was 91.4%（32/35） ,CEUS depicted metastases in SLNs with sensitivity,specificity and accuracy of 90.9% ,90.5%, 91.0%,respectively. Conclusions CEUS can be used to detect and assess SLNs and has very high value for clinical application.