高频彩色多普勒超声联合MRI在乳腺癌腋下转移性淋巴结鉴别诊断中的应用

Application of high frequency color Doppler ultrasonography combined with MRI in differential diagnosis of axillary metastatic lymph node of breast cancer

目的探讨高频彩色多普勒超声联合MRI在乳腺癌腋下转移性淋巴结鉴别诊断中的应用效果。方法采取回顾性分析的方法,收集该院2015年1月至2016年6月收治的乳腺癌患者96例,所有患者术前均行高频彩色多普勒超声联合MRI检查,以乳腺癌根治术后病理结果作为金标准。对高频彩色多普勒超声和MRI的诊断结果进行分析。结果 96例患者中,转移性淋巴结52例(54.17%);MRI检查结果显示,转移淋巴结的长径、短径、皮质厚度,以及淋巴门消失、边缘不规则、周围脂肪间隙模糊、高DWI信号、不均匀强化比例均明显高于未转移淋巴结,ADC值明显低于未转移淋巴结(P<0.05),高频彩色多普勒超声检查结果显示,转移淋巴结L/S<2、皮质厚度≥3mm、混合型或者周边性血流、2级+3级血流比例均明显高于未转移淋巴结(P<0.05);高频彩色多普勒超声联合MRI诊断转移性淋巴结的灵敏度、特异度、准确度、阳性预测值及阴性预测值均明显升高。结论高频彩色多普勒超声联合MRI可有效提高乳腺癌腋下转移性淋巴结的鉴别诊断效果。

Objective To investigate the application of high frequency color Doppler ultrasonography combined with MRI in differential diagnosis of axillary metastatic lymph node of breast cancer.Methods The methods of retrospective analysis were used,39 cases of breast cancer patients admitted from January 2015 to June 2016 were collected,high frequency color Doppler ultrasonography and MRI were performed on each patient before operation,the pathological results after radical mastectomy were considered as the gold standard.The diagnostic results of high frequency color Doppler ultrasonography and MRI were analyzed.Results There were 52 metastatic lymph node(54.17%)among 96 breast cancer;MRI check results showed that,the proportion of long diameter,short diameter,cortical thickness and lymph node disappeared,irregular edge,blurred peripheral fat space,high DWI signal and inhomogeneous enhancement in patients with lymph node metastasis were significantly higher than those without lymph node metastasis,the ADC value was significantly lower than that in patients without lymph node metastasis(P<0.05);High frequency color Doppler ultrasonography check results showed that,the L/S<2,cortical thickness greater than 3 mm,mixed type or peripheral blood flow,2 grade and 3 grade stageblood flow ratio in patients with lymph node metastasis were significantly higher than that of patients without lymph node metastasis(P<0.05);The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of high frequency color Doppler ultrasonography combined with MRI in the diagnosis of metastatic lymph nodes were significantly increased(P<0.05).Conclusion High frequency color Doppler ultrasonography combined with MRI can effectively improve the differential diagnosis of axillary metastatic lymph nodes of breast cancer.