摘要
目的探讨经皮超声造影(CEUS)对乳腺癌腋窝前哨淋巴结转移的诊断及定位价值。方法167例乳腺癌患者,术前采用经皮CEUS探查前哨淋巴结(SLN),评估SLN造影图像特征并对其进行导丝定位,与术中美蓝定位结果及病理结果对比,研究其诊断及定位效能。结果CEUS诊断SLN转移性敏感度为91.0%、特异度为88.0%、阳性预测值为83.6%、阴性预测值为93.6%、Kappa值为0.78;若以SLN未见转移灶或腋窝低负荷状态为阴性标准,其诊断敏感度为91.7%、特异度为98.9%、阳性预测值为91.7%、阴性预测值为98.9%。对SLN定位显示:CEUS显示率、美蓝显示率、二者联合显示率分别为94.5%(292/309)、96.2%(301/309)、99.1%(207/309)。结论经皮CEUS对SLN定位及诊断效能好,一定程度上指导乳腺癌患者手术方式选择。
Objective To investigate the value of percutaneous contrast-enhanced ultrasound(CEUS)in the diagnosis and localization of axillary sentinel lymph node(SLN)metastasis in breast cancer patients.Methods The SLN features were evaluated and wire-localization was performed in 167 breast cancer patients receiving percutaneous CEUS before operation.The diagnosis and localization efficiencies were assessed through comparing with the intraoperative methylene blue localization and pathological results.Results The sensitivity,specificity,positive predictive value,negative predictive value and Kappa value of CEUS for SLN metastasis were 91.0%,88.0%,83.6%,93.6%and 0.78 Kappa,respectively.If non-SLN metastasis or low axillary tumor load was taken as the negative criteria,the sensitivity,specificity,positive predictive value and negative predictive value were 91.7%,98.9%,91.7%and 98.9%,respectively.The display rates of SLN localization by CEUS,methylene blue and their combination were 94.5%(292/309),96.2%(301/309)and 99.1%(207/309),respectively.Conclusion Percutaneous CEUS is effective for the localization and diagnosis of SLN,and can guide the selection of surgical procedures for breast cancer patients.
作者
刘婷
郑巍
余美琴
王婧玲
聂小艳
熊海蔚
许志辉
张丽丽
LIU Ting;ZHENG Wei;YU Mei-qin;WANG Jin-ling;NIE Xiao-yan;XIONG Hai-wei;XU Zhi-hui;ZHANG Li-li(Department of Medical Ultrasound,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)
出处
《实用临床医学（江西）》
CAS
2023年第5期48-51,97,共5页
Practical Clinical Medicine
关键词
经皮超声造影
乳腺癌
腋窝前哨淋巴结
诊断价值
定位
percutaneous contrast-enhanced ultrasound
breast cancer
axillary sentinel lymph node
diagnostic value
localization
