多模态超声在术前乳腺癌前哨淋巴结性质判定中的应用价值  

The value of multimodal ultrasound in preoperative evaluation of sentinel lymph nodes of breast cancer

作　　者：蔡婷 董维露 刘慧 张芹 赵淳 吴意赟 CAI Ting;DONG Weilu;LIU Hui;ZHANG Qin;ZHAO Chun;WU Yiyun(Department of Ultrasound Medicine,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu Province,China)

机构地区：[1]南京中医药大学附属医院超声医学科,江苏南京210029

出　　处：《肿瘤影像学》2024年第5期530-535,共6页Oncoradiology

基　　金：江苏省科技厅(BE2022789);江苏省第六期“333高层次人才培养工程”(2022-3-25-069);江苏省中医院创新发展项目(Y2021ZR06)。

摘　　要：目的:探讨多模态超声在术前诊断乳腺癌前哨淋巴结性质的价值。方法:回顾并分析2018年6月—2021年7月于南京中医药大学附属医院经病理学检查证实的乳腺癌患者术前前哨淋巴结常规超声及超声造影图像特征,比较单独应用常规超声检查、经静脉超声造影、经淋巴管超声造影及三者联合应用,对于乳腺癌前哨淋巴结性质的诊断效能。结果:纳入122例乳腺癌患者共计122枚前哨淋巴结病理学检查显示27枚前哨淋巴结发生转移,95枚未发生转移;常规超声诊断前哨淋巴结性质的灵敏度、特异度、阳性预测值(positive predictive value,PPV)、准确度分别为70.37%、84.21%、55.88%、81.14%,经淋巴管造影诊断前哨淋巴结性质的灵敏度、特异度、PPV、准确度分别为66.67%、93.68%、75.00%、87.70%,经静脉造影诊断前哨淋巴结性质的灵敏度、特异度、PPV、准确度分别为44.44%、94.74%、70.59%、83.61%,三者联合诊断前哨淋巴结性质的灵敏度、特异度、PPV、准确度分别为77.80%、75.79%、47.73%、76.23%;经淋巴管造影组及经静脉造影组的特异度分别与常规超声及三者联合组差异有统计学意义,经淋巴管造影组PPV与三者联合组差异有统计学意义,经淋巴管造影组准确度与三者联合组差异有统计学意义(P<0.05)。结论:应用多模态超声能够在术前乳腺癌前哨淋巴结的性质评价中提供更高的诊断价值。Objective:To explore the application value of multimodal ultasound in preoperative diagnosis of sentinel lymph node characteristics in breast cancer.Methods:The characteristics of ultrasound and contrast-enhanced images of sentinel lymph nodes in patients with breast cancer which confirmed by pathology in the Affiliated Hospital of Nanjing University of Chinese Medicine from June 2018 to July 2021 were analyzed retrospectively to compare the diagnostic efficacy of conventional ultrasound,translymphatic and transvenous contrast-enhanced ultrasound,and the combination of three techniques in sentinel lymph nodes.Results:A total of 122 breast cancer patients with 122 sentinel lymph nodes pathologically showing 27 sentinel lymph nodes with metastasis and 95 without metastasis were included.The sensitivity,specificity,positive predictive value,and accuracy of the conventional ultrasound group were 70.37%,84.21%,55.88%,81.14%.The sensitivity,specificity,positive predictive value,and accuracy of the translymphatic group were 66.67%,93.68%,75.00%,87.70%.The sensitivity,specificity,positive predictive value,and accuracy of the transvenous group were 44.44%,94.74%,70.59%,83.61%.And those of the combination group were 77.80%,75.79%,47.73%,76.23%.According to the diagnostic efficiency between different groups,the specificity of the translymphatic group and the transvenous group was significantly different from that of the conventional ultrasound group and the combination group,respectively.There was a significant difference in the positive predictive value between the translymphatic group and the combination group;There was a significant difference in accuracy between the translymphatic group and the combination group(P<0.05).Conclusion:Multimodal ultrasound can provide a higher diagnostic value in preoperative evaluation of sentinel lymph nodes in breast cancer.

关 键 词：乳腺癌 超声造影 前哨淋巴结 多模态超声 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]