超声弹性成像联合常规超声在乳腺癌腋窝淋巴结转移诊断中的价值

Value of elastography combined with conventional ultrasound in diagnosis of axillary lymph node metastasis in breast cancer patients

目的:探讨超声弹性成像在乳腺癌患者腋窝淋巴结状态判断中的作用,研究其与常规超声的联合诊断价值。方法:回顾性研究术前进行过常规超声及超声弹性成像的132例乳腺癌患者腋窝淋巴结132个,常规超声观察病灶大小、纵横比、皮质厚度、淋巴门状态和血流模式等特征,分析超声弹性成像观察淋巴结内部较硬区域的占比。以最终手术或穿刺标本病理学检查结果为金标准,分析对比常规超声、超声弹性成像及两者联用对腋窝淋巴结转移的诊断价值。结果:常规超声的诊断灵敏度、特异度和准确率分别为77.0%、87.9%、81.8%,联合诊断中平行诊断和系列诊断的灵敏度、特异度和准确率分别为83.8%、84.5%、84.1%和56.1%、100%、72.7%。结论:超声弹性成像可作为常规超声检查的辅助手段以帮助判断乳腺癌腋窝淋巴结状态。

Objective: To evaluate the role of ultrasound elastography in the diagnosis of axillary lymph node(ALN) metastasis in the patients with breast cancer. Methods: The conventional ultrasound features [longitudinal diameter, longitudinal-to-transverse diameter ratio(L/T ratio), cortical thickness, status of the hilum, vascular pattern] and elastography features(proportion of hard area within each lymph node) of 132 axillary lymph nodes examined before biopsy or surgery were analyzed. The histopathological diagnosis was regarded as gold standard to investigate the diagnostic values of different methods. Results: The sensitivity, specificity and accuracy were 77.0%, 87.9% and 81.8% respectively for conventional ultrasound, 83.8%, 84.5% and 84.1% respectively for disjunctive combination, 56.1%, 100% and 72.7% respectively for conjunctive combination. Conclusion: Elastography is a useful adjuvant tool to help conventional ultrasound in the preoperative assessment of axillary lymph node status in the breast cancer patients.