|
|
|
| Comparison of diagnostic value of breast MRI and ultrasonography in axillary lymph node metastasis of breast cancer |
| DU Lan YANG Jingchun▲ CHANG Ying |
| Department of Ultrasound, Xuanwu Hospital, Capital Medical University, Beijing 100054, China |
|
|
|
Abstract Objective To study the clinical value of breast MRI and axillary ultrasonography in the differential diagnosis of axillary lymph node metastasis in breast cancer patients. Methods The data of 229 patients with breast cancer underwent radical mastectomy, modified radical mastectomy or radical mastectomy in Xuanwu Hospital from October 2016 to September 2017 were retrospectively analyzed. All patients underwent preoperative MRI and axillary ultrasound examination, underwent radical mastectomy and axillary lymph node dissection, and underwent routine pathological examination of lymph nodes. The correlation between MRI and axillary ultrasound findings and postoperative pathological findings were observed. Results Axillary lymph node metastasis was detected in 102 of 229 patients, and no metastasis was detected in 127 patients. 108 cases of axillary lymph node metastasis were detected by MRI, of which 91 cases were consistent with the cases, 17 cases were misdiagnosed, and 11 cases were missed. Axillary lymph node metastasis was detected in 98 cases by ultrasound, 80 cases were consistent with pathological diagnosis, 18 cases were misdiagnosed, and 22 cases were missed diagnosis. The sensitive of MRI in diagnosis of axillary lymph node metastasis was higher than that of axillary ultrasound, with statistically significant difference (P < 0.05). There was significant difference in specificity and accuracy of diagnosis between MRI and axillary ultrasound (P > 0.05). The specificity of MRI positive and axillary ultrasound positive in diagnosis of axillary lymph node metastasis was higher than that of MRI, axillary ultrasound and MRI positive or axillary ultrasound positive (P ＜ 0.05). The sensitivity of MRI positive or axillary ultrasound positive was higher than that of MRI, axillary ultrasound, MRI positive and axillary ultrasound positive (P ＜ 0.05). Conclusion The breast MRI and axillary ultrasonography are important means of detecting lymph node metastasis in breast cancer, both positive is helpful for the diagnosis of axillary lymph node metastasis, one positive in the two indicator is helpful for the diagnosis of axillary lymph node metastasis, clinical can flexibly according to the actual situation.
|
|
|
|
|
|
[1] 赵一博，白玲，唐英，等.超声引导腋窝淋巴结穿刺活检在诊断乳腺癌腋窝淋巴结转移中的临床价值研究[J].军事医学，2015，39（7）：541-545.
[2] 郑瑛，陈钦，梁至洁，等.淋巴结转移率评价腋窝淋巴结转移的保治疗乳腺癌患者预后的价值[J].中华肿瘤杂志，2015，37（1）：41-46.
[3] 高薇，王文，米成嵘.二维超声及彩色多普勒超声对乳腺癌腋窝结定性诊断价值[J].宁夏医学杂志，2014，36（6）：534-535.
[4] 赵巧玲，阮骊韬，张华，等.实时组织弹性成像对乳腺癌腋窝淋巴结转移的诊断价值评估[J].西安交通大学学报：医学版，2013，34（5）：656-658，663.
[5] 姜惠文，于晓丹.超声诊断乳腺癌腋窝淋巴结转移的影像学表现分析及研究[J].影像技术，2017，3：35-37.
[6] 邹霞，李泉水，熊华花，等.超声在乳腺癌患者腋窝淋巴结转移相关因素分析中的应用[J].临床超声医学杂志，2014，16（6）：392-394.
[7] 王永南，张安泰，万舰，等.MRI在早期乳腺癌腋窝淋巴结转移中的诊断价值[J].国际外科杂志，2013，40（3）：153-156.
[8] 殷正昕，沈坤炜，李亚芬，等.术前乳腺B超及MRI检查对乳腺癌患者腋窝淋巴结状态评估的准确性[J].中华普通外科杂志，2013，28（4）：259-262.
[9] Javid S，Segara D，Lotfi P，et al. Can breast MRI predict axillary lymph node metastasis in women undergoing neoadjuvantchemotherapy [J]. Ann Surg Oncol，2010，17（7）：1841-1846.
[10] 王绍东. B型超声诊断乳腺癌腋窝淋巴结转移的价值探析[J].检验医学与临床，2014，11（5）：632-633.
[11] 陈泽梅，余晋涛，范肖丽.高频多普勒超声探讨乳腺癌腋窝淋巴结转移的价值[J].实用医技杂志，2011，18（11）：1131-1133.
[12] 王慧，王成峰，王靖，等.影像学检查手段在早期乳腺癌及其淋巴结评价方面的意义[J].癌症进展，2014，12（6）：576-579.
[13] 王子函，王岳月，滕长胜，等.乳腺癌新辅助化疗前腔镜前哨淋巴结活检术的临床应用[J].临床和实验医学杂志，2016，15（11）：1108-1111.
[14] 中国抗癌协会专业委员会.中国抗癌协会乳腺癌诊治指南与规范（2011年版）[J].中国癌症杂志，2011，21（6）：367-417.
[15] 辛灵，陈路增，张虹，等.乳腺癌腋窝淋巴结转移的超声诊断价值及临床病理相关性分析[J].中华外科杂志，2014， 52（12）：924-728.
[16] 徐慧，楼俭茹，周梅. MRI评价乳腺癌腋窝淋巴结转移的价值[J].实用放射学杂志，2016，32（12）：1871-1875.
[17] 王蕊，佟凌霄，齐娜.超声检查在女性腋窝肿块诊断中的应用[J].中国实验诊断学，2014，18（10）：1710-1713.
[18] 蒋蓓琦，章华，庄志刚.腋窝超声在乳腺癌前啥淋巴结活检中应用价值[J].中华临床医师杂志：电子版，2013， 7（5）：1975-1979.
[19] Cools-Lartigue J，Meterissian S. Accuracy of axillary ultrasound in the diagnosis of nodal metastasis in invasive breast cancer：a review [J]. World J Surg，2012，36（1）：46-54.
[20] 吴佩琪，刘春玲，刘再毅，等.钼靶、CT与DCE-MRI评价乳腺癌淋巴结转移的价值[J].南方医科大学学报，2016， 36（4）：493-499. |
|
|
|
