二维剪切波弹性成像联合常规超声对乳腺浸润性导管癌腋窝淋巴结转移的诊断价值

Diagnostic value of 2D-SWE combined with conventional ultrasound for axillary lymph node metastasis in patients with breast invasive ductal carcinoma

目的:分析二维剪切波弹性成像(2D-SWE)联合常规超声对乳腺浸润性导管癌腋窝淋巴结转移的诊断价值。方法:选择120例乳腺浸润性导管癌患者为研究对象,对患者同侧120个腋窝淋巴结进行2D-SWE检查和常规超声检查,根据术后腋窝淋巴结的病理学活检结果分为转移组与非转移组;比较两组腋窝淋巴结2D-SWE评分、常规超声特征,使用多因素Logistic回归分析2D-SWE评分和常规超声特征与乳腺浸润性导管癌腋窝淋巴结转移的关系,分析2D-SWE联合常规超声诊断乳腺浸润性导管癌腋窝淋巴结转移的准确度、特异度和灵敏度。结果:转移组腋窝淋巴结纵径、纵横径比值、皮质厚度均大于非转移组,淋巴门消失占比、周边型或混合型血流模式占比均高于非转移组(均P<0.05);转移组腋窝淋巴结2D-SWE评分高于非转移组(P<0.05);经多因素Logistic回归分析,纵径、纵横径比值、皮质厚度、淋巴门消失、周边型或混合型血流模式和2D-SWE评分均是乳腺浸润性导管癌腋窝淋巴结转移的独立预测因素(均P<0.05);在2D-SWE联合常规超声诊断乳腺浸润性导管癌腋窝淋巴结转移中,平行诊断和系列诊断的准确度、特异度、灵敏度分别为81.67%、78.85%、83.82%和86.67%、100.00%、76.47%。结论:2D-SWE联合常规超声可以提高乳腺浸润性导管癌腋窝淋巴结转移的诊断效能。

Objective:To analyze the diagnostic value of two-dimensional shear-wave elastography(2D-SWE)combined with conventional ultrasound for axillary lymph node metastasis in patients with breast invasive ductal carcinoma.Methods:A total of 120 patients with breast invasive ductal carcinoma were selected as the research objects.The ipsilateral 120 axillary lymph nodes of the patients were examined by 2D-SWE and conventional ultrasound.According to the pathological biopsy results of axillary lymph nodes after surgery,the patients were divided into metastatic group and non-metastatic group.The 2D-SWE score and conventional ultrasound features of axillary lymph nodes were compared between the two groups.Multivariate Logistic regression was used to analyze the relationship between 2D-SWE score and conventional ultrasound features with axillary lymph node metastasis of breast invasive ductal carcinoma.The accuracy,specificity and sensitivity of 2D-SWE combined with conventional ultrasound in the diagnosis of axillary lymph node metastasis of breast invasive ductal carcinoma was analyzed.Results:The ratio of longitudinal and transverse diameters and cortical thickness in the metastatic group were significantly higher than those in the non-metastatic group,and the proportion of lymphatic hilus disappearance and peripheral or mixed flow patterns were significantly higher than those in the non-metastatic group(all P<0.05).The 2D-SWE score of axillary lymph nodes in the metastatic group was higher than that in the non-metastatic group(P<0.05).Multivariate Logistic regression analysis showed that longitudinal diameter,transverse diameter ratio,cortical thickness,hilar disappearance,peripheral or mixed flow pattern and 2D-SWE score were independent predictors of axillary lymph node metastasis in breast invasive ductal carcinoma(all P<0.05).In the diagnosis of axillary lymph node metastasis of breast invasive ductal carcinoma by 2D-SWE combined with conventional ultrasound,the accuracy,specificity and sensitivity of parallel diagnosis and serial diagnosis were 81.67%,78.85%,83.82%and 86.67%,100.00%,76.47%.Conclusion:2D-SWE combined with conventional ultrasound can improve the diagnostic efficiency of axillary lymph node metastasis of breast invasive ductal carcinoma.