CAJ | 학술논문

目的探讨超声造影对诊断乳腺癌腋窝淋巴结转移的应用价值.方法对141例浸润型乳腺癌患者行乳腺病灶及腋窝淋巴结常规超声检查后,再对腋窝淋巴结进行超声造影,先用目测法观察淋巴结超声造影增强模式,再用QontraXt软件分析超声造影时间-强度曲线参数.根据超声造影灌注特点,将腋窝淋巴结分为淋巴结转移组(有转移组)和无淋巴结转移组(无转移组),并与病理检查结果相比较.增强模式之间的对比采用χ2检验,造影参数用单因素方差分析.结果淋巴结有转移组灌注模式表现为不均匀增强型或无增强,淋巴结无转移组表现为均匀型增强,两组灌注模式之间的差异有统计学意义(P=0.000).两组造影剂到达时间、达峰时间、峰值强度之间的差异无统计学意义 (P值分别为0.129、0.094、0.140).淋巴结实质内高灌注区与低灌注区的差值(SImax- SImin)有转移组大于无转移组(P=0.000).以SImax- SImin 值大于28为最佳临界点,鉴别的灵敏度为93.3%,特异度为80.8%.结论超声造影对鉴别乳腺癌腋窝淋巴结转移有一定的临床价值..
목적 탐토초성조영대진단유선암액와림파결전이적응용개치.방법 대141례침윤형유선암환자행유선병조급액와림파결상규초성검사후,재대액와림파결진행초성조영,선용목측법관찰림파결초성조영증강모식,재용QontraXt연건분석초성조영시간-강도곡선삼수.근거초성조영관주특점,장액와림파결분위림파결전이조(유전이조)화무림파결전이조(무전이조),병여병리검사결과상비교.증강모식지간적대비채용χ2검험,조영삼수용단인소방차분석.결과 림파결유전이조관주모식표현위불균균증강형혹무증강,림파결무전이조표현위균균형증강,량조관주모식지간적차이유통계학의의(P=0.000).량조조영제도체시간、체봉시간、봉치강도지간적차이무통계학의의 (P치분별위0.129、0.094、0.140).림파결실질내고관주구여저관주구적차치(SImax- SImin)유전이조대우무전이조(P=0.000).이SImax- SImin 치대우28위최가림계점,감별적령민도위93.3%,특이도위80.8%.결론 초성조영대감별유선암액와림파결전이유일정적림상개치..
Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in detection of metastatic axillary lymph nodes in patients with breast carcinoma. Methods The breasts and axillae of 141 patients with breast carcinoma were examined with Ultrasound scans, followed by ultrasonography and CEUS of axillary lymph nodes. The perfusion patterns were assessed by direct visualization method. QontraXt software was subsequently used to determine the wash-in and wash-out parameters of each node. The axillary lymph nodes were divided into metastatic and nonmetastatic groups according to the perfusion features and were compared with the histopathologic diagnosis. The correlation of CEUS patterns with histopathology was analyzed by chi-square test. One-way analysis of variance was used to assess differences in perfusion parameters among the nodes. Results Homogeneous enhancement patterns were more frequently associated with non-metastasis of nodes, while heterogeneous enhancement patterns or avascular patterns were mostly suggestive of metastasis of nodes, with statistical difference between the two groups. No statistically significant difference was found in the arrival time, time to peak intensity, and peak signal intensity between the two groups(P= 0.129, 0.094, and 0.140, respectively). The difference between the maximum signal intensity and minimum signal intensity (Simax- Simin) were more obvious in metastatic nodes than in nonmetastatic ones(P=0.000). And histopathologic diagnosis could be predicted with a sensitivity of 93.3% and a specificity of 80.8% by the standardized value of Simax- Simin above 28. Conclusion Contrast-enhanced ultrasonography play a role in clinically discriminating metastatic from nonmetastatic lymph nodes in patients with invasive breast cancer.