超声造影诊断乳腺癌转移性SLN的价值及与超声引导下CNB病理结果的一致性探究OA
The Value of Contrast-enhanced Ultrasound in the Diagnosis of Metastatic SLN in Breast Cancer and its Consistency with the Pathological Results of CNB Guided by Ultrasound
目的:分析超声造影(CEUS)应用于乳腺癌转移性前哨淋巴结(SLN)的诊断价值,并分析与超声引导下经皮粗针穿刺活检(CNB)病理结果的一致性,为临床工作提供影像学参考.方法:选取2021年5月至2023年5月内蒙古医科大学附属医院收治的150例乳腺癌患者,均接受CEUS检查及超声引导下CNB病理检查,并以此病理结果为金标准,评估CEUS对SLN转移的诊断效能,并比较CEUS与常规超声的诊断结果.结果:150例患者中,41例(27.33%)经超声引导下CNB病理证实为SLN转移,109例(72.67%)为SLN无转移.CEUS诊断SLN转移的敏感度为87.80%(36/41),特异度为 97.25%(106/109),准确率为 94.67%(142/150),均高于常规超声(敏感度60.98%,特异度98.17%,准确率88.00%).CEUS诊断乳腺癌SLN转移、无转移患者SLN的达峰强度、达峰平均速度、灌注强度差、纵径、横径比较差异明显(P<0.05);SLN转移Ⅰ型分布占比低于SLN无转移患者,Ⅱ型及Ⅲ型分布占比高于SLN无转移患者(P<0.05);CEUS与CNB病理结果的一致性Kappa值为0.864(95%CI:0.772～0.956),符合率为94.67%.结论:CEUS在乳腺癌转移性SLN诊断中具有较高的诊断效能,与CNB病理结果一致性极好(Kappa值为0.864),可为临床诊断提供可靠依据.
Objective:To explore the value of contrast-enhanced ultrasound(CEUS)in the diagnosis of metastatic sentinel lymph node(SLN)of breast cancer,and to analyze the consistency with the pathological results of ultrasound-guided percutaneous coarse needle aspiration biopsy(CNB),so as to provide imaging reference for clinical work.Methods:A total of 150 patients with breast cancer admitted to The Affiliated Hospital of Inner Mongolia Medical University from May 2021 to May 2023 were selected,and all underwent CEUS examination and ultrasonic-guided CNB pathological examination,and the pathological results were used as the gold standard to evaluate the diagnostic efficacy of CEUS for SLN metastasis,and the diagnostic results of CEUS and conventional ultrasound were compared.Results:Among the 150 patients,41(27.33%)were confirmed to have SLN metastasis by ultrasound-guided CNB pathology,and 109(72.67%)were confirmed to have no SLN metastasis.The sensitivity,specificity,and accuracy of CEUS in diagnosing SLN metastasis were 87.80%(36/41),97.25%(106/109),and 94.67%(142/150),respectively,which were higher than those of conventional ultrasound(sensitivity 60.98%,specificity 98.17%,and accuracy 88.00%).CEUS diagnosis of breast cancer SLN metastasis,peak intensity,peak average velocity,perfusion intensity difference,longitudinal diameter,and transverse diameter of SLN in patients with and without metastasis showed significant differences(P<0.05).The proportion of type Ⅰ distribution of SLN metastasis was lower than that of patients without SLN metastasis,while the proportion of type Ⅱ and type Ⅲ distribution was higher than that of patients without SLN metastasis(P<0.05).The consistency of Kappa value between CEUS and CNB pathological results was 0.864(95%CI:0.772～0.956),with a coincidence rate of 94.67%.Conclusion:CEUS has high diagnostic efficacy in the diagnosis of metastatic SLN in breast cancer,and has excellent consistency with CNB pathological results(Kappa value of 0.864),providing a reliable basis for clinical diagnosis.
崔岩;申文凤
内蒙古医科大学附属医院 超声医学科,内蒙古 010010内蒙古医科大学附属医院 超声医学科,内蒙古 010010
医药卫生
SLN超声造影经皮粗针穿刺活检乳腺癌一致性Kappa值
SLNcontrast-enhanced ultrasoundpercutaneous coarse needle aspiration biopsybreast cancerconsistencyKappa value
《影像科学与光化学》 2026 (3)
91-96,108,7
内蒙古自治区自然科学基金面上(联合)项目[2022MS(LH)1209].
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