超声造影在评估乳腺癌腋窝及内乳淋巴结转移中的价值

Value of contrast-enhanced ultrasound in evaluating axillary and internal mammary lymph node metastasis of breast cancer

目的探讨超声造影(contrast-enhanced ultrasonography,CEUS)在浸润性乳腺癌腋窝及内乳淋巴结转移中的诊断价值。方法选取2020年9月至2022年9月期间就诊于重庆医科大学附属第一医院乳腺甲状腺外科的100例浸润性乳腺癌患者,术前完善CEUS检查,动态观察淋巴结的灌注顺序、增强模式及增强顺序。比较转移性淋巴结与良性淋巴结的CEUS特征;以术后病理结果为金标准,分析CEUS评估淋巴结状态的诊断效能。结果100例患者中28例患者术后病理活检确诊为转移性腋窝淋巴结,CEUS评估腋窝淋巴结状态的敏感度、特异度、准确率、阳性预测率和阴性预测率分别为71.4%、87.5%、83.0%、69.0%和88.7%。9例患者CEUS检查提示内乳淋巴结转移,术后病理学检查证实5例患者内乳淋巴结为转移淋巴结,CEUS的阳性预测率为55.6%。结论CEUS能较好地评估腋窝及内乳淋巴结的转移状态。

Objective To explore the diagnostic value of contrast-enhanced ultrasonography(CEUS)in axillary and internal mammary lymph node metastasis of invasive breast cancer.Methods A total of 100 patients with invasive breast cancer treated from September 2020 to September 2022 were selected.Preoperative CEUS examination was completed,and the perfusion sequence,enhancement mode and enhancement sequence of lymph nodes were dynamically observed.The CEUS characteristics of metastatic and benign lymph nodes were compared.Using postoperative pathological results as the gold standard,the diagnostic efficacy of CEUS in evaluating lymph node status was analyzed.Results Among the 100 patients,28 patients were diagnosed with metastatic axillary lymph nodes(ALN)by pathological biopsy.The sensitivity,specificity,accuracy,positive prediction rate and negative prediction rate of CEUS in evaluating ALN status were 71.4%,87.5%,83.0%,69.0%and 88.7%,respectively.In 9 patients,CEUS showed internal mammary lymph node metastasis,and postoperative pathological examination confirmed that 5 patients had internal mammary lymph node metastasis,so the positive predictive rate of CEUS was 55.6%.Conclusion CEUS can evaluate the metastatic status of axillary and internal mammary lymph nodes.