皮肤黑素瘤切除术后超声检测前哨淋巴结在淋巴结转移诊断中的价值  

Value of ultrasound in diagnosis of lymph nodal metastasis after cutaneous melanoma operation by examing sentinel lymph nodes

作　　者：魏俊涛[1,2] 李慧敏[1,2] 郭志[1,2] 陆梦[1,2] 

机构地区：[1]三峡大学第三临床医学院 [2]葛洲坝中心医院超声科,湖北省宜昌市443002

出　　处：《临床超声医学杂志》2013年第4期232-234,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声检测前哨淋巴结(SLN)在皮肤黑素瘤切除术后淋巴结转移诊断中的价值。方法 19例皮肤黑素瘤手术切除后患者,超声检查皮肤疤痕处周围及相应淋巴引流区域,对检测出的可疑转移性SLN进行超声引导下穿刺活检,并与超声检查结果对照。结果超声检出肿大SLN31枚,病理诊断转移性SLN11枚,非转移性SLN20枚。超声检查结果与病理结果的总符合率为77.4%(24/31)。转移性SLN与非转移性SLN在纵横比、内部回声、血管分布及阻力指数的差异有统计学意义(P<0.05),而淋巴结门髓质主干动脉收缩期峰值速度、舒张末期峰值速度的差异无统计学意义。4枚较小SLN超声随访,1枚大小、形态发生明显变化,病理检查为阳性。结论超声在皮肤黑素瘤切除术后淋巴结转移初步诊断、引导穿刺活检、指导临床治疗方面有一定的价值。Objective To investigate the value of ultrasound in diagnosis of lymph nodal metastasis after cutaneous melanoma operation by examining sentinel lymph nodes. Methods Around skin scar and regions lymph flow with ninteen patients after cutaneous melanoma operation were scanned by ultrasonography, fine needle aspirated sentinel lymph nodes which were suspected metastasis by ultrasound-guidance,then compared with uhrasonographic result. Results A total of 31 enlarged sentinel lymph nodes were identified by ultrasonography. Eleven were detected positive and twenty were detected negative by pathological examination. Total coincidence rate of the ultrasonographic findings and pathological results was 77.4% （24/31）. There were significant differences in L/S, image, peripheral blood, RI between two kinds of sentinel lymph node （P 〈 0.05 ）, while there were no significant differences in medullary truncus arteriosus Vs and Vd. Four small lymph nodes were followed-up with ultrasonography,one of these was changed in shape and size,it was detected positive by pathological examination. Conclusion Ultrasonography has a higher value for primary diagnosing lymph nodal metastasis after cutaneous melanoma operation, fine needle aspiration by ultrasound-guidance and guiding clinical therapy as well.

关 键 词：超声检查 前哨淋巴结 黑素瘤 淋巴结转移 

分 类 号：R739.5[医药卫生—肿瘤] R445.1[医药卫生—临床医学]