The effect of sonographic elastography on diagnosing the axillary lymph nodes in patients with breast cancer
-
摘要: 目的 探讨弹性成像技术对超声诊断乳腺癌腋窝淋巴结性质准确性的提升作用。 方法 回顾性分析134例乳腺癌患者160个癌转移腋窝淋巴结,分别采用常规超声技术和弹性成像技术术前诊断腋窝淋巴结性质,并以术后病理组织学诊断为标准,评价2种诊断方法不同评价指标对判断反应性和转移性淋巴结的准确率,同时采用McNemar检验方法对常规超声方法和弹性成像方法的敏感度和特异性进行分析。 结果 常规超声按照淋巴结长短轴比、皮质偏心增厚程度、血流丰富程度和血流类型4个指标对反应性淋巴结诊出率分别为29.2%、41.5%、26.2%和16.9%;对转移性淋巴结诊出率分别为69.5%、68.4%、73.7%和86.3%;弹性成像超声检查时,评分1、2、3、4分时对反应性淋巴结诊出率分别为80.0%、58.5%、84.6%和38.5%;对转移性淋巴结诊出率分别为31.6%、60.0%、50.5%和64.2%。弹性成像方法相对于常规超声方法而言,敏感度由63.2%提高至73.8%(P=0.014),特异性由64.4%提高至72.9%,差异均具有统计学意义(P=0.043)。弹性成像评分法曲线下面积(0.829)大于常规超声(0.763),差异有统计学意义(P<0.05)。 结论 弹性成像方法能够提高判断乳腺癌患者术前腋窝淋巴结性质的准确性和特异性,为临床实施腋窝淋巴结清扫提供可靠的依据。Abstract: Objective To explore the effect of sonographic elastography on diagnosing the axillary lymph nodes in patients with breast cancer. Methods One hundred and thirty four patients of breast cancer with 160 axillary lymph nodes were analyzed respectively in this study.The properties of axillary lymph nodes were evaluated by conventional ultrasound and sonographic elastography,respectively.The accuracy of two different evaluation methods for reactive and metastatic lymph nodes were evaluated according to pathological diagnosis results.The sensitiveness and specificity was analyzed by the McNemar method. Results In the conventional ultrasound method,the ratio of diagnosis for L/S<2,the thickness of lymph node cortex≥0.3 cm,the extent for blood flow abundance,blood type for reactive lymph nodes are 29.2%,41.5%,26.2%,and 16.9%,respectively;and for lymph node metastasis are 69.5%,68.4%,73.7%,and 86.3%,respectively.In the sonographic elastography method,the ratio of diagnosis for 1 grade,2 grades,3 grades,and 4 grades of reactive lymph nodes are 80.0%,58.5%,84.6%,and 38.5%;and for lymph node metastasis are 31.6%,60.0%,50.5%,and 64.2%,respectively.Compared with the conventional ultrasound method,the sonographic elastography can increase the susceptibility from 63.2% to 73.8%(P=0.014),and also can increase the specificity significantly from 64.4% to 72.9%,the difference had statistically significance(P=0.043).The area under the curve in the elastography score(0.829) was greater than the conventional ultrasound(0.763).The difference was statistically significant(P<0.05). Conclusion The sonographic elastography method can improve the accuracy and specificity in the judging of the properties of axillary lymph nodes of patients with breast cancer,and can offer the reliable basis for clinical axillary lymph node dissection.
-
Key words:
- Breast cancer /
- Axillary lymph node /
- The sonographic elastography method
点击查看大图
计量
- 文章访问数: 219
- HTML全文浏览量: 13
- PDF下载量: 0
- 被引次数: 0