磁共振间质淋巴造影诊断乳腺癌腋窝淋巴结转移

Interstitial MR lymphography in diagnosis of axillary lymph node metastasis of breast cancer

目的探讨MR间质淋巴造影诊断乳腺癌腋窝淋巴结转移的价值。方法对36例浸润性乳腺癌患者于术前行MR间质淋巴造影检查,观察前哨淋巴结(SLN)、乳腺引流淋巴管情况;术中在美蓝引导下行SLN活检;根据活检结果评价MR间质淋巴造影显示SLN的效果及诊断腋窝淋巴结转移敏感度、特异度及准确率。结果 MR间质淋巴造影显示每例患者SLN平均(1.33±0.53)枚,美蓝为示踪剂显示SLN平均(1.19±0.47)枚,差异无统计学意义(t=1.711,P=0.096)。MR间质淋巴造影判断淋巴结转移阳性10例,术后病理结果全部为淋巴结转移;淋巴造影阴性25例,24例术后病理结果未见转移,1例为假阴性。MR间质淋巴造影诊断乳腺癌患者淋巴转移的敏感度为90.91%(10/11),特异度为100%(24/24),准确率为97.14%(34/35)。结论 MR间质淋巴造影能有效、可靠地显示乳腺癌引流区域淋巴管、淋巴结并判断良恶性,具有较好发展前景。

Objective To investigate the value of interstitial MR lymphography in diagnosis of axillary lymph node metastasis of breast cancer. Methods A total of 36 patients with invasive breast cancer underwent preoperative interstitial MR lymphography, and the sentinel lymph node （SLN） and lymphatic drainage situation were observed. Meilan guided SLN biopsy was performed during surgical operation, and the results were taken as standards for assessing the sensitivity, specificity and accuracy of interstitial MR lymphography. Results Interstitial MR lymphography showed that the average number of SLN was 1.330.53, which was 1.190.47 （t=1.711, P=0.096） guided by Meilan. Interstitial MR lymphography determined lymph node metastasis in 10 cases, consistent with pathological results. No metastasis was found with interstitial MR lymphography in 25 cases, pathologic results proved 24 cases without metastasis, but 1 case of false negative. The sensitivity, specificity and accuracy of interstitial MR lymphography in diagnosis of axillary lymph node metastasis of breast cancer was 90.91% （10/11）, 100% （24/24） and 97.14% （34/35）, respectively. Conclusion Interstitial MR lymphography is effective and reliable for displaying regional lymphatic situation and judging benign and malignant lymph node in patients with breast cancer, therefore has great prospects.