SMI联合常规超声对小乳腺癌腋窝淋巴结转移的诊断价值

Value of SMI Combined with Conventional Ultrasound in Axillary Lymph Node Metastasis of Small Breast Cancer

目的探讨SMI联合常规超声对小乳腺癌腋窝淋巴结转移的诊断价值。方法选取女性小乳腺癌患者60例,回顾性分析所有患者的常规超声及SMI临床资料,比较二者的声像图,评价二者单独使用及联合使用对小乳腺癌腋窝淋巴结转移情况的诊断效能。结果常规超声对小乳腺癌患者腋窝淋巴结的声像图表现显示,23个(38.33%)长短径比≤2,22个(36.67%)皮髓质比≥1,24个(40.00%)最大皮质厚度≥3 mm,Adler分级34个(56.67%)0~Ⅰ级、26个(43.33%)Ⅱ~Ⅲ级。SMI的Adler分级显示,反应增生组以Ⅰ级、Ⅱ级血流为主,分别占到17.86%、64.29%;转移组以Ⅱ级、Ⅲ级血流为主,分别占到43.75%、28.13%,二者差异具有统计学意义(P<0.05)。常规超声诊断转移淋巴结的敏感性是79.31%,特异性是70.97%;SMI诊断转移淋巴结的敏感性是89.29%,特异性是78.13%;两者联合诊断转移淋巴结的敏感性是96.77%,特异性是93.10%。结论 SMI联合常规超声检测小乳腺癌的腋窝淋巴结转移情况,可以提高诊断效能,具有广阔的临床应用前景。

Objective To explore the value of SMI combined with conventional ultrasound in axillary lymph node metastasis of small breast cancer. Methods Selected 60 patients with small breast cancer. All patients were retrospectively analyzed by routine ultrasound and SMI clinical data. Sonograms of the 2 technologies were compared. Evaluation of the 2 alone and combined use of small breast cancer axillary lymph node metastases diagnostic efficacy. Results Ultrasound on small breast cancer by conventional ultrasound showed 23（ 38. 33%） had an aspect ratio of 2,22（ 36. 67%） with a corticomedullary ratio of ≥1,24（ 40. 00%） with a maximum cortical thickness 34 mm（ 56. 67%） 0 - Ⅰ and 26（ 43. 33%） Ⅱ - Ⅲ Adler grading. According to the Adler scale of SMI,the grade Ⅰ and grade Ⅱ blood flow were the main reaction group,accounting for 17. 86% and 64. 29%respectively. The grade Ⅱ and grade Ⅲ blood flow in the metastatic group were mainly 43. 75% and 28. 13%,The difference between the 2 groups was statistically significant（ P〈0. 05）. The sensitivity of routine ultrasound in the diagnosis of metastatic lymph nodes was 79. 31% and the specificity was 70. 97%. The sensitivity of SMI in diagnosing metastatic lymph nodes was89. 29% and the specificity was 78. 13%. The sensitivity of the combined diagnosis of lymph node metastasis was 96. 77% and the specificity was 93. 10%. Conclusion SMI combined with conventional ultrasound detection of small breast cancer axillary lymph node metastases,can improve the diagnostic efficacy,having broad prospects for clinical application.