经皮超声造影诊断乳腺癌前哨淋巴结转移

Percutaneous contrast-enhanced ultrasonography in diagnosis of metastatic sentinel lymph nodes from breast carcinoma

目的探讨经皮CEUS诊断乳腺癌前哨淋巴结(SLN)转移的价值。方法对79例乳腺癌患者行二维及彩色多普勒超声检查,并行前哨淋巴结经皮CEUS,采用目测法分析造影模式,利用时间-强度曲线获得相关参数,并将CEUS结果与病理进行对比分析。结果 79例中,32例存在前哨淋巴结转移(转移组),47例无转移(无转移组)。转移组前哨淋巴结增强模式以不均匀增强为主,无转移组以均匀增强为主(P<0.001);转移组与无转移组灌注强度差、达峰强度及达峰平均强度的差异均有统计学意义(P均<0.05),而造影剂到达时间、达峰时间及上升斜率差异均无统计学意义(P均>0.05)。结论经皮CEUS对预测乳腺癌SLN转移有一定临床应用价值。

Objective To explore the value of percutaneous CEUS in diagnosis of metastatic sentinel lymph nodes （SLN） in patients with breast carcinoma. Methods Totally 79 patients underwent two-dimensional ultrasound and CDFI, and SLN of breast carcinoma were examined with CEUS. The perfusion patterns were assessed using direct visualization meth- od, the related parameters were gotten with time-intensity curve, and were compared with the histopathological results. Results In all 79 cases, 32 cases were identified with metastatic lymph nodes （metastatic group）, 47 cases were identified without metastatic lymph nodes （non-metastatic group）. Heterogeneous enhancement patterns were mostly associated with metastasis lymph nodes, while homogeneous enhancement patterns more frequently suggested of non-metastasis lymph nodes （P^0. 001）. No statistically significant difference was found in the arrival time, time to peak intensity nor rising gradient between the two groups （all P^0.05）. Statistically significant difference was found in terms of the perfusion in- tensity, peak intensity and average of peak intensity between two groups （all P%0.05）. Conclusion CEUS has high value in diagnosing metastatic SLN in patients with breast carcinoma.