常规超声联合超声造影在乳腺癌转移性前哨淋巴结中的诊断价值

Diagnostic value of conventional ultrasound combined with contrast-enhanced ultrasound in metastatic sentinel lymph node of breast cancer

目的探讨常规超声联合超声造影(CEUS)在乳腺癌转移性前哨淋巴结(SLN)中的诊断价值。方法选择2017年1月至2020年9月就诊于我院的120例乳腺癌患者作为研究对象,均实施常规超声、CEUS检查,比较常规超声、CEUS单项及联合检查的诊断效能。结果参照手术病理诊断结果,联合检查对乳腺癌转移性SLN的诊断灵敏度、准确度、阳性预测值、阴性预测值均高于常规超声,差异具有统计学意义(P<0.05);联合检查对乳腺癌转移性SLN的诊断灵敏度高于CEUS,差异具有统计学意义(P<0.05)。联合检查、CEUS与手术病理诊断结果之间呈高度一致,Kappa值为0.895、0.802。转移性SLN组的不均匀强化、周边型血流信号占比均高于非转移性SLN组,差异具有统计学意义(P<0.05);转移性SLN组的均匀强化、门型血流信号占比均低于非转移性SLN组,差异具有统计学意义(P<0.05)。结论常规超声联合CEUS对乳腺癌转移性SLN的诊断价值良好,诊断灵敏度较高。

Objective To investigate the diagnostic value of conventional ultrasound combined with contrast-enhanced ultrasound(CEUS)in metastatic sentinel lymph node(SLN)of breast cancer.Methods A total of 120 breast cancer patients admitted in our hospital from January 2017 to September 2020 were selected as the research objects.All patients underwent conventional ultrasound and CEUS examination.The diagnostic efficacy of conventional ultrasound and CEUS single examination or combined examination were compared.Results According to the pathological diagnosis results of operation,the sensitivity,accuracy,positive predictive value and negative predictive value of combined examination in the diagnosis of metastatic SLN of breast cancer were higher than those of conventional ultrasound,and the differences were statistically significant(P<0.05);the sensitivity of combined examinationin the diagnosis of metastatic SLN of breast cancer was higher than that of CEUS,and the difference was statistically significant(P<0.05).The results of combined examination,CEUS and surgical pathological diagnosis were highly consistent,and the Kappa values were 0.895 and 0.802.The proportion of uneven enhancement and peripheral blood flow signals in metastatic SLN group were higher than those in non metastatic SLN group,and the differences were statistically significant(P<0.05);the proportion of homogeneous enhancement and portal blood flow signal in metastatic SLN group were lower than those in non metastatic SLN group,and the differences were statistically significant(P<0.05).Conclusion Conventional ultrasound combined with CEUS has a good diagnostic value for metastatic SLN of breast cancer,with high diagnostic sensitivity.