超声评估乳癌患者腋下淋巴结转移的临床价值

The Value of Ultrasonography to Evaluate Axillary Lymph Node Metastasis in the Patients with Breast Carcinoma

目的:通过对乳癌原发灶的灰阶超声,彩色多普勒(Color Doppler Flow Imaging,CDFI),频谱多普勒检查,评估腋下淋巴结有无转移。方法:术前运用超声检测122例乳癌患者原发灶的声学特性,术后根据腋下淋巴结有无转移分为两组,比较两组间年龄,原发灶的部位(象限分布),大小,内部回声,有无卫星灶,CDFI,频谱多普勒有无显著差异。结果:患者的年龄,内部回声,有无卫星灶,两组间无显著性差异;原发灶的大小,部位两组间有显著差异;CDFI显示:腋下淋巴结阳性组原发灶内血流比阴性组丰富(P<0.05);频谱多普勒显示:阳性组峰值流速(Vmax)高于阴性组(P<0.01),其中Vmax>33cm/s的14例患者腋下淋巴结均呈阳性。阻力指数(RI):两组间无显著差异,但如把RI=1的8位患者单独列组,两组间有显著差异(P<0.01)。结论:运用灰阶超声、多谱勒超声评价癌肿的声学特性,对判断腋下淋巴结状态,指导临床治疗,有一定帮助。

Objective: To scan breast cancer and evaluate axillary lymph node metastasis with gray- scale US,color Doppler and spectrum Doppler. Methods: One- hundred twenty two women with primary breast cancer were studied. For comparison of ultrasonography featrues (size, location, echo, satellite of cancer, CDFI, spectrum Doppler), patients were divided into two groups-, breast cancer with malignant LN and breast cancer with normal LN. Results: Age, echo and satellite of cancer had been demonstrated equally in breast cancer with malignant LN and breast cancer with normal LN. Size and location were demonstrated unequally in two groups. Color flow and Vmax were significantly higher in breast cancer with malignant LN. The Vmax were higher than 33cm/s in all 14 patients of breast cancer with malignant LN. RI were demonstrated equally in two groups. If 8 patients(RI = 1) separated and list another group, RI demonstrated unequally. Conclusion: Gray-scale US and color Doppler flow features may identify breast cancer with malignant LN and breast cancer with normal LN.