高频彩色多普勒超声对乳腺癌腋窝淋巴结良恶性的诊断价值

Diagnostic value of high frequency color Doppler ultrasound in benign and malignant axillary lymph nodes of breast cancer

目的探讨高频彩色多普勒超声对乳腺癌腋窝淋巴结良恶性的诊断价值。方法对200例乳腺癌患者均开展常规超声和高频彩色多普勒超声检查,将病理检查结果作为金标准,比较两种检查方法的诊断效能,并比较乳腺癌良恶性腋窝淋巴结的高频彩色多普勒超声声像特征、信号分布情况及血流分级。结果病理检查结果显示,腋窝淋巴结良性患者120例,恶性患者80例。高频彩色多普勒超声诊断恶性腋窝淋巴结患者的灵敏度、特异度、阳性预测值、阴性预测值及准确度均高于常规超声。病理检查结果显示腋窝淋巴结共230枚,其中良性130枚,恶性100枚。恶性腋窝淋巴结皮质为偏心增厚、长短径比值≤2.0、融合、有钙化斑的比例均明显高于良性腋窝淋巴结,差异均有统计学意义(P﹤0.01)。恶性腋窝淋巴结信号分布为周边型及血流分级为Ⅲ级的比例均高于良性腋窝淋巴结,差异均有统计学意义(P﹤0.05)。结论高频彩色多普勒超声诊断乳腺癌恶性腋窝淋巴结的灵敏度、特异度均较高,不仅能提高患者的诊断准确度,还能及时明确腋窝淋巴结的声像特征及血流信号分布情况,临床应用价值较高。

Objective To investigate the value of high frequency color Doppler ultrasound in the diagnosis of benign and malignant axillary lymph nodes in breast cancer.Method A total of 200 breast cancer patients were selected and received routine ultrasound and high frequency color Doppler ultrasound examination;the pathological results were used as the gold standard to compare the diagnostic efficiency of the two methods,and the acoustic characteristics,signal distribution and blood flow grading of high frequency color Doppler ultrasound in the benign and malignant axillary lymph nodes of breast cancer were compared.Result Pathological results showed there were 120 patients with benign axillary lymph nodes and 80 patients with malignant axillary lymph nodes.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of high frequency color Doppler ultrasound in diagnosing malignant axillary lymph nodes patients were significantly higher than the routine ultrasound.The pathological examination showed a total of 230 axillary lymph nodes,with 130 benign and 100 malignant nodes.The proportion of eccentric thickened cortex,ratio of long/short diameter≤2.0,fusion and calcification plaques in malignant axillary lymph nodes were significantly higher than those in benign axillary lymph nodes(P<0.01);the proportion of peripheral signal distribution and grade III blood flow in malignant axillary lymph nodes were higher than those in benign axillary lymph nodes(P<0.05).Conclusion The sensitivity and specificity of high frequency color Doppler ultrasound in diagnosing malignant axillary lymph nodes of are high,which can not only improve the diagnosis accuracy of patients,but also confirm the acoustic characteristics and blood flow signal distribution,with high clinical application value.