经肿块周围皮下与经肿块周围腺体内注射超声造影剂检测乳腺癌前哨淋巴结的对比研究

发布时间：2018-10-29 12:52

【摘要】：目的探讨超声造影检测乳腺癌前哨淋巴结（SLN）的最佳造影剂注射部位和其临床价值。方法对65例乳腺癌患者分别经肿块周围皮下及肿块周围腺体内注射超声造影剂，观察并记录腋窝淋巴结造影增强情况。最终与亚甲蓝染色及病理结果对照。结果1.本研究65例乳腺癌患者中，经肿块周围皮下注射超声造影剂检出SLN57例共79枚，检出率为86.81%（79/91），经肿块周围腺体内注射SLN检出率为58.24%（53/91)，对比二者SLN检出情况差异有统计学意义（P0.05）； 2.经肿块周围皮下注射超声造影判定SLN转移的准确度为88.61%（70/79），敏感度为94.92%（56/59），特异度为70.00%（14/20）；经肿块周围腺体内注射超声造影检测SLN的准确度为86.79%（46/53），敏感为度82.50%（33/40），特异度为100%（13/13），二者判定SLN转移与否的准确度、敏感度和特异度之间差异无统计学意义（P0.05）； 3.经肿块周围皮下注射超声造影剂SLN开始增强时间、达峰时间均较经腺体内注射时间短，且二者之间差异有统计学意义（P0.05）。结论1.经乳腺肿块周围皮下CEUS可以较为准确地检出SLN并判断其是否转移。 2.经乳腺肿块周围皮下注射超声造影剂后，SLN显影速度快，且操作简单、易于掌握，因而有较高的临床实用价值。
[Abstract]:Objective to investigate the best contrast media injection site and its clinical value for detecting sentinel lymph node (SLN) in breast cancer by contrast-enhanced ultrasonography. Methods 65 patients with breast cancer were treated by subcutaneous and intraglandular injection of ultrasound contrast media respectively. The contrast enhancement of axillary lymph nodes was observed and recorded. The final results were compared with methylene blue staining and pathology. Result 1. In this study, 79 cases (86.81%) of SLN57 were detected by subcutaneous injection of ultrasound contrast agent around the tumor, and 58.24% (53 / 91) by intraglandular injection of SLN. There was significant difference in SLN detection between the two groups (P0.05). 2. The accuracy, sensitivity, specificity and specificity of SLN metastasis were 88.61% (70 / 79), 94.92% (56 / 59) and 70.00% (14 / 20), respectively. The accuracy, sensitivity and specificity of intraglandular injection echocardiography in detecting SLN were 86.79% (46 / 53), 82.50% (33 / 40) and 100% (13 / 13), respectively. There was no significant difference between sensitivity and specificity (P0.05). 3. The enhancement time of SLN was shorter than that of intraglandular injection, and the difference was statistically significant (P0.05). Conclusion 1. SLN can be detected accurately by subcutaneous CEUS around breast mass and whether it is metastasized or not. 2. After subcutaneous injection of ultrasound contrast agent into the surrounding breast masses, SLN has a high clinical value because of its rapid development, simple operation and easy control.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R737.9

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