超声弹性成像联合常规超声评分对乳腺癌腋窝淋巴结转移的诊断价值  

The value of ultrasound elastography combined with conventional ultrasound scoring method in diagnosis of axillary lymph nodes in breast cancer

作　　者：郭碧萍 李艳宁[1] 徐丽芳[1] 卢露[1] 李富[2] 赵娅雯[1] 庞玉艳[3] 

机构地区：[1]广西医科大学第一附属医院超声科,南宁530021 [2]广西医科大学第一附属医院胃肠腺体外科,南宁530021 [3]广西医科大学第一附属医院病理科,南宁530021

出　　处：《广西医科大学学报》2017年第6期832-834,共3页Journal of Guangxi Medical University

基　　金：广西自然科学基金资助项目(No.2014GXNSFAA118279)

摘　　要：目的:探讨超声弹性成像(UE)联合常规超声(US)评分对乳腺癌腋窝淋巴结转移的诊断价值。方法:对174例女性乳腺癌患者同侧174枚腋窝淋巴结,行US及UE技术检测,二维超声对淋巴结形态进行分型并赋值评分,彩色多普勒血流显像(CDFI)对淋巴结血流进行分型并赋值评分,UE对淋巴结进行弹性评分并赋值评分。以病理诊断结果为金标准,比较174枚腋窝淋巴结转移性与非转移性的超声评分差异。采用受试者工作曲线(ROC曲线)分析UE联合US诊断乳腺癌腋窝淋巴结转移的灵敏度、特异度及准确率。结果:乳腺癌转移性腋窝淋巴结96枚,平均评分(3.67±1.72)分;非转移性78枚,平均评分(1.41±1.30)分,两者比较差异有统计学意义(P<0.05)。UE联合US评分以3分为最佳临界值,ROC曲线下面积为0.845,诊断乳腺癌腋窝淋巴结转移的灵敏度为74.0%,特异度为82.1%,准确率为77.6%。结论:UE联合US评分有助于乳腺癌转移性与非转移性腋窝淋巴结的鉴别,转移性腋窝淋巴结评分较高,在乳腺癌腋窝淋巴结转移的诊断中具有较高的临床价值。Objective： To explore the value of ultrasound elastography combined with conventional ultrasound scoring method in the diagnosis of axillary lymph nodes （ALD） in breast cancer. Methods： 174 ipsi lateral ALD in 174 female patients with breast cancer were detected by uhrasonic elastography （UE） and conventional ultrasound （US）. The shape and blood flow of ALD were classified and scored by two-dimensional ultrasound and color Doppler flow imaging （CDFI）, respectively. The ultrasound scoring was per formed after elastography. The ALD metastasis was estimated by using ultrasound scoring system and was compared with pathological results. The sensitivity, specificity and accuracy of UE combined with US for diagnosis of ALD metastasis were analyzed by receiver operating characteristics （ROC） curve. Results： The mean scores of 96 metastatic and 78 non-metastatic ALD were （3.67±1.72） and （1.41±1.30） points, re spectively, and the difference was significant （P〈0.05）. The area under the ROC curve was 0. 845 with the optimal threshold value of 3. The sensitivity, specificity and accuracy was 74. 0%, 82.1% and 77.6%, respectively. Conclusion： UE combined with US scoring method could contribute to the distinguish of metastatic and non-metastatic ALD. It is of great clinical value in the diagnosis of ALD with breast cancer.

关 键 词：UE评分 腋窝淋巴结 乳腺癌 转移 

分 类 号：R445.1[医药卫生—影像医学与核医学]