多排螺旋CT对乳腺癌腋窝淋巴结的术前评估价值

Value of MDCT in Preoperative Evaluation of Axillary Lymph Nodes in Breast Cancer

目的探讨多排螺旋CT(MDCT)对乳腺癌腋窝淋巴结的术前评估价值。方法选取2015年2月至2017年2月在我院手术治疗的乳腺癌患者82例,术前均行MDCT检查,与病理结果进行比较。结果 82例乳腺癌患者共检测腋窝淋巴结161枚,术后病理证实转移78枚,未转移83枚;转移性淋巴结长径和短径分别为(15.82±4.28)mm和(8.10±1.27)mm,明显高于未转移性淋巴结,差异有统计学意义(P<0.05),而长短径比值为(1.98±0.61),明显低于未转移性淋巴结,差异有统计学意义(P<0.05);转移性淋巴结淋巴门消失和边缘模糊的比例分别为79.49%和60.26%,明显高于未转移性淋巴结,差异有统计学意义(P<0.05);MDCT判断腋窝淋巴结转移的灵敏度、特异度、阳性预测值和阴性预测值分别为84.62%、72.29%、74.16%和83.33%。转移性和未转移性淋巴结平扫和增强扫描CT值比较差异无统计学意义(P>0.05)。结论 MDCT在乳腺癌腋窝淋巴结术前评估中有重要价值,可作为淋巴结活检的补充手段。

Objective To evaluate the value of multi-slice spiral CT（MDCT） in preoperative evaluation of axillary lymph nodes in breast cancer. Methods 82 cases of breast cancer patients who were going to be operated in our hospital from February 2015 to February 2017 were selected. MDCT examinations were performed before operation and the results were compared with pathological findings. Results A total of 161 axillary lymph nodes were detected in 82 breast cancer patients,78 lymph nodes of metastasis were confirmed by pathology, and 83 lymph nodes had no metastasis;The long diameter and short diameter of metastatic lymph nodes were（ 15.82 ± 4. 28 ）mm and（ 8.10 ± 1.27 ）mm ,respectively, significantly higher than those of non metastatic lymph nodes, and the difference was statistically significant （P 〈 O. 05 ） , The ratio of long and short diameter was （ 1.98 ± 0. 61 ）, signifi- cantly lower than that of non metastatic lymph nodes, and the difference was statistically significant （P 〈 O. 05） ;The proportion of disappearance of hilar lymph nodes and marginal blurring of metastatic lymph nodes was 79. 49% and 60. 26%, respectively, which was significantly higher than that in non metastatic lymph nodes, statistically significant（P 〈 0. 05 ） ; The sensitivity, specific- ity,positive predictive value and negative predictive value of MDCT for axillary lymph node metastasis were 84. 62% ,72. 29%, 74. 16% and 83.33%. , respectively. There was no significant difference in plain and enhanced CT value between metastatic lymph nodes and non metastatic lymph nodes （ P 〉 0. 05 ）. Conclusion MDCT has important value in preoperative evaluation of axillary lymph nodes in breast cancer, and it can be used as a supplementary method for lymph node biopsy.