超声造影剂不同注射方法对乳腺腋窝淋巴结的显示情况比较

Comparison of the Ultrasonic Manifestation of Breast Axillary Nodes with Acoustic Contrast Agents Injected by Different Methods

[目的]比较经乳晕,肿瘤周围及肘静脉注射超声造影剂声诺维对乳腺腋窝淋巴结的显示情况,以选择一种合适的注射方法进行乳腺腋窝淋巴结的研究.[方法]45例乳腺良性病变患者,随机分为三组,分别将声诺维注入乳晕、肿瘤周围及肘静脉部,采用CPS造影成像技术于患者同侧腋窝部观察淋巴结增强情况.比较不同注射方法下淋巴结的检出情况及显影增强的起始时间,持续时间等.[结果]三组间淋巴结检出率比较无统计学差异（P〉0.05）.乳晕和肿块周围注射组淋巴结开始增强时间快于肘静脉组,持续时间长于肘静脉注射组（P〈0.05）,而乳晕和肿块周围注射两组间无统计学差异（P〉0.05）.造影后淋巴结显示的病例数及个数均高于造影前（P〈0.05）,三组间淋巴结发现的例数和个数无统计学差异（P〉0.05）.[结论]超声造影可明显提高腋窝淋巴结的显示率.经乳晕、肿瘤周围较肘静脉部注射造影剂淋巴结、淋巴管的显像更佳,其中乳晕注射由于操作更为简便可行,是较为理想的方法.

[Objective] To compare the ultrasonic manifestation of breast axillary nodes through the injection of acoustic contrast agent Snovue by mammary areola, peri-tumor or ulnar vein in order to choose a suitable injection method for the study of breast axillary nodes. [Methods] Forty five patients with breast benign disease were divided into three groups. Snovue was injected into mammary areola, peri-tumor and ulnar vein, respectively. CPS contrast imaging technique was used to observe the enhancement of the same axillary nodes of patients. The detection rate of lymph node, the onset and lasting time of the imaging enhancement with different injection methods were compared. [Results] There was no statistical difference in the detection rate of lymph node among three groups（ P〉0.05）. The onset time of enhancement in mammary areola and peri-tumor injection groups were faster than those in ulnar vein injection group, and the duration of enhancement in mammary areola and peri-tumor injection groups were longer than that in ulnar vein injection group（ P〈0.05）, but there was no significant difference between mammary areola injection group and peri-tumor injection group（ P〉0.05）. The patients and the number of lymph node after contrast were more than those before contrast（ P〉0.05）, but there was no significant difference among 3 groups（ P〉0. 05）. [Conclusion]The ultrasonic contrast can increase the detection rate of axillary nodes. The lymph node and lymphatic imaging in groups with the injection of acoustic contrast agent by mammary areola and peri-tumor are better than those in group with the injection by ulnar vein. The injection of acoustic contrast agent by mammary areola is simple and feasible, so it is an ideal method.