增强CT在乳腺癌诊断、腋窝淋巴结转移诊断中的价值及影像特征观察

Value and Imaging Characteristics of Contrast-enhanced CT in the Diagnosis of Breast Cancer and Axillary Lymph Node Metastasis

目的探究增强CT在乳腺癌诊断、腋窝淋巴结转移中的价值,分析其影像学特征。方法回顾收集97例疑似乳腺癌患者临床及影像学资料,对比病理学检查结果,计算增强CT对乳腺癌、乳腺癌腋窝淋巴结转移的诊断效能,分析影像学特征。结果97例疑似乳腺癌患者经病理组织学检查确诊乳腺癌72例、乳腺良性病变25例,存在乳腺癌腋窝淋巴结转移34例、未转移38例;经增强CT检查诊断乳腺癌敏感度91.67%、特异度88.00%、准确率90.72%,与病理诊断的kappa值为0.767,具有高度的一致性;经增强CT诊断乳腺癌腋窝淋巴结转移的敏感度94.12%、特异度86.84%、准确率90.28%,与病理诊断的kappa值为0.806,具有极高度的一致性;乳腺癌增强CT多见形态不规则(47/72)和边缘不规则(51/72),病灶均有不同程度强化,增强方式以环形强化为主(51/72),血流动力学特征中多呈快进快出型强化(52/72);乳腺癌乳腺癌淋巴结转移者增强CT的淋巴结最大径、CT值均显著增加,多见淋巴门结构消失。结论增强CT可有效显示乳腺癌、乳腺癌腋窝淋巴结转移的影像学特征,对乳腺癌、腋窝淋巴结转移均具有较高诊断价值。

Objective To explore the value of contrast-enhanced CT in the diagnosis of breast cancer and axillary lymph node metastasis,and to analyze its imaging characteristics.Methods The clinical data and imaging data of 97 patients with suspected breast cancer were retrospectively collected and were compared with the results of pathological examination.The diagnostic efficiency of contrast-enhanced CT on breast cancer and axillary lymph node metastasis was calculated,and the imaging characteristics were analyzed.Results 72 cases of breast cancer and 25 cases of benign breast lesions were diagnosed by histopathological examination among 97 patients with suspected breast cancer,including 34 cases of axillary lymph node metastasis and 38 cases of non-metastasis.The sensitivity,specificity and accuracy rate of contrast-enhanced CT in the diagnosis of breast cancer were 91.67%88.00%and 90.72%,and kappa value with pathological diagnosis was 0.767,with high consistency.The sensitivity,specificity,accuracy rate and kappa value with pathological diagnosis of ontrast-enhanced CT in diagnosing axillary lymph node metastasis of breast cancer were 94.12%,86.84%,90.28%and 0.806,with high consistency.Contrast-enhanced CT of breast cancer showed irregular shape(47/72)and irregular margin(51/72).All lesions were with enhancements in different degrees,with enhancement mode of mainly ring enhancement(51/72)and hemodynamic characteristic of fast-in and fast-out enhancement(52/72).The maximum diameter and CT value of lymph nodes in patients with axillary lymph node metastasis were significantly increased,and the lymphatic hilum structure disappeared.Conclusion Contrast-enhanced CT can effectively display the imaging characteristics of breast cancer and axillary lymph node metastasis,and has high diagnostic value on breast cancer and axillary lymph node metastasis.