超声弹性成像联合高频多普勒彩超在早期浸润性乳腺癌腋窝淋巴结转移诊断中的价值

Diagnostic Value of Ultrsounic Elastography Combined with High-frequency Color Doppler Flow Imaging for Axillary Lymph Node Metastasis in Early Invasive Breast Cancer

目的探究超声弹性成像(UE)联合高频多普勒彩超(CDFI)在早期浸润性乳腺癌腋窝淋巴结转移诊断中的价值。方法选择100例早期浸润性乳腺癌患者,收集其UE、CDFI检查结果,比较转移性淋巴结及非转移性淋巴结患者的UE评分、弹性应变率及CDFI征象,并分析2种方法检查结果与病理学检查结果的一致性;以病理学检查结果为金标准,比较2种方法单独检查及联合检查对乳腺癌腋窝淋巴结转移的诊断效能及诊断价值。结果转移性淋巴结组的UE评分低于非转移性淋巴结组,弹性应变率高于非转移性淋巴结组,转移性淋巴结组长短轴比<2、皮质厚度≥3 mm、腋窝异常低回声区等CDFI征象发生率高于非转移性淋巴结组(P<0.05)。联合检查结果与病理性检查结果的一致性(Kappa=0.779)高于UE(Kappa=0.519)、CDFI(Kappa=0.469);联合检查诊断腋窝淋巴结转移的准确度及特异度高于CDFI(P<0.05);联合检查诊断腋窝淋巴结转移的AUC值大于UE、CDFI单独检查(0.843 vs 0.764、0.743,P<0.05)。结论UE联合CDFI对早期浸润性乳腺癌腋窝淋巴结转移具有较高的诊断价值,且诊断准确度及特异度较高。

Objective To explore the diagnostic value of ultrsounic elastography(UE)combined with high-frequency color Doppler flow imaging(CDFI)for axillary lymph node metastasis in early invasive breast cancer.Methods A total of 100 patients with early invasive breast cancer were enrolled.The results of UE and CDFI were collected to compare UE score,elastic strain rate and CDFI signs between patients with metastatic and non-metastatic lymph nodes.The results consistency between the 2 methods and pathological examination was analyzed.Taking pathological examination results as the golden standard,diagnostic efficiency and value of the two methods and their combination for axillary lymph node metastasis in breast cancer were compared.Results UE score in metastatic lymph node group was lower than that in non-metastatic lymph node group,elastic strain rate was higher than that in non-metastatic lymph node group,and incidence of CDFI signs(ratio of long to short axis less than 2,cortical thickness not shorter than 3mm,abnormal axillary hypoechoic area)was higher than that in non-metastatic lymph node group(P<0.05).The results consistency between combined examination and pathological examination was higher than that of UE and CDFI(Kappa:0.779 vs 0.519,0.469).The accuracy and specificity of combined examination in the diagnosis of axillary lymph node metastasis were higher than those of CDFI(P<0.05),and AUC was greater than that of UE and CDFI alone(0.843 vs 0.764,0.743,P<0.05).Conclusion UE combined with CDFI is of relatively higher diagnostic value for axillary lymph node metastasis in early invasive breast cancer,and its diagnostic accuracy and specificity are higher.