分析超声诊断乳腺癌腋窝淋巴结转移的影像学表现及其临床效果

To Analyze the Imaging Features and Clinical Effects of Ultrasound Diagnosis of Axillary Lymph Node Metastasis in Breast Cancer

目的本次研究重点分析临床诊断乳腺癌腋窝淋巴结转移情况的过程中,应用超声诊断技术的临床诊断优势以及影像学表现。方法以随机抽取的方式选取研究对象,60例研究对象均来自我院,被确诊为患有乳腺癌,在2021年1月至2022年12月期间接受腋窝淋巴结转移筛查,将手术病理诊断结果作为诊断标准,为患者实施超声诊断,观察超声诊断的诊断效果,统计超声诊断的影像学特征。结果通过超声检查,发现有53.33%的患者腋窝淋巴结发生转移,通过手术病理诊断,48.33%的患者腋窝淋巴结发生转移,由此可见,超声诊断应用于早期乳腺癌患者临床诊断过程中的特异度、灵敏度以及准确率分别为77.42%、86.21%、81.67%,与手术病理诊断结果相比,两种诊断方式一致性较高(Kappa=0.84)。通过超声诊断,在影像学特征方面,腋窝淋巴结转移患者的病灶边界不够清晰,存在微小钙化现象,回声不均匀,与腋窝淋巴结未转移患者相比,纵横径比<1.5的患者占比更大,差异具有统计学意义(P<0.05);在血流信号分布方面,未转移患者门型占比更高,转移患者周边型占比更高,差异具有统计学意义(P<0.05);在皮质形态方面,未转移患者狭窄型占比更高,转移患者组偏心增厚型占比更高,差异具有统计学意义(P<0.05);两类患者均无淋巴门型,而且两类患者淋巴门型与向心增厚型占比对比差异不显著(P>0.05)。结论诊断乳腺癌腋窝淋巴结转移情况的过程中,通过超声诊断技术,可以为临床诊断治疗提供参考依据,具有较高特异度以及灵敏度,影像学特征明显,诊断价值较高,可广泛应用。

Objective This study focused on the clinical diagnosis of breast cancer axillary lymph node metastases in the process,the application of ultrasound diagnostic technology clinical diagnostic advantages and imaging findings.Method The subjects were randomly selected.60 cases subjects were diagnosed with breast cancer in our hospital and received screening for axillary lymph node metastasis during January 2021 to December 2022.The results of surgical pathological diagnosis were used as diagnostic criteria to perform ultrasonic diagnosis for the patients,observe the diagnostic effect of ultrasonic diagnosis,and make statistics on the imaging features of ultrasonic diagnosis.Results It was found that 53.33%of patients had axillary lymph node metastasis through ultrasound examination,and 48.33%of patients had axillary lymph node metastasis through surgical and pathological diagnosis.Therefore,the specificity,sensitivity and accuracy of ultrasound diagnosis in the clinical diagnosis of early breast cancer patients were 77.42%,86.21%and 81.67%,respectively.Compared with surgical pathological diagnosis results,the two diagnostic methods showed high consistency(Kappa=0.84).According to ultrasonic diagnosis,in terms of imaging features,the lesion boundaries of patients with axillary lymph node metastasis were not clear enough,with micro-calcification and uneven echo.Compared with patients without axillary lymph node metastasis,the ratio of transverse and transverse diameter<1.5 accounted for a larger proportion,and the difference was statistically significant(P<0.05).In terms of blood flow signal distribution,the proportion of gate type in patients without metastasis was higher,and the proportion of peripheral type in patients with metastasis was higher,and the difference was statistically significant(P<0.05).In terms of cortical morphology,the proportion of stenosis type was higher in patients without metastasis,and the proportion of eccentric thickening type was higher in patients with metastasis,and the difference was statistically significant(P<0.05).There was no significant difference in the proportion of lymphatic portal type and cardiac thickening type between the two groups of patients(P>0.05).Conclusion In the process of diagnosis of axillary lymph node metastasis of breast cancer,ultrasonic diagnosis technology can provide reference for clinical diagnosis and treatment.It has high specificity and sensitivity,obvious imaging characteristics,high diagnostic value,and can be widely used.