【摘要】：目的：探討超聲彈性成像技術(shù)（ultrasonic elastography,UE)及二維超聲(Two-dimensional ultrasound,2D-US)對(duì)乳腺癌腋窩淋巴結(jié)(Axillary lymphnode,ALN)轉(zhuǎn)移的診斷價(jià)值，提高超聲對(duì)ALN轉(zhuǎn)移狀態(tài)的鑒別診斷水平。 方法：研究對(duì)象為2012年12月至2013年12月于廣西醫(yī)科大學(xué)第一附屬醫(yī)院胃腸腺體外科住院并接受手術(shù)治療的女性乳腺癌患者共94例，對(duì)乳腺癌同側(cè)ALN94枚行2D-US及UE檢測(cè)，觀察聲像圖特點(diǎn)，，測(cè)量大小、皮質(zhì)厚并計(jì)算縱橫比（Long diameter/short diameter ratio， L/S），行彈性評(píng)分。與術(shù)后病理結(jié)果對(duì)照分析，評(píng)價(jià)超聲對(duì)乳腺癌患者同側(cè)ALN轉(zhuǎn)移狀態(tài)的診斷價(jià)值。 結(jié)果：1.2D-US乳腺癌同側(cè)轉(zhuǎn)移性與非轉(zhuǎn)移性ALN相比：淋巴結(jié)L/S＜2.0；皮質(zhì)增厚≥0.3cm；淋巴門消失，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。2.非轉(zhuǎn)移性ALN的UE評(píng)分多為1、2分，轉(zhuǎn)移性ALN多為3、4分。以UE≥3分為界值診斷ALN轉(zhuǎn)移的靈敏度、特異度、準(zhǔn)確率分別為84.31%（43/51）、81.40%（35/43）、82.98%（78/94）。2D-US、UE及二者聯(lián)合診斷乳腺癌ALN轉(zhuǎn)移的準(zhǔn)確率分別為75.53%，82.98%，92.55%，二者聯(lián)合診斷準(zhǔn)確率高于二者單獨(dú)應(yīng)用，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。UE評(píng)分2、3分的ALN中，圖像藍(lán)色區(qū)域多出現(xiàn)在淋巴結(jié)周邊，與淋巴結(jié)皮質(zhì)對(duì)應(yīng)，藍(lán)色僅出現(xiàn)在皮質(zhì)占80%（28/35），20%（7/35）皮質(zhì)及髓質(zhì)均出現(xiàn)藍(lán)色，該部分ALN轉(zhuǎn)移性與非轉(zhuǎn)移性組藍(lán)色分布差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。 結(jié)論：UE對(duì)乳腺癌ALN轉(zhuǎn)移狀態(tài)的判斷具有較高診斷價(jià)值，非轉(zhuǎn)移性ALN的彈性評(píng)分以1、2分為主，轉(zhuǎn)移性ALN以3、4分為主。2D-US聯(lián)合UE檢查能提高乳腺癌ALN轉(zhuǎn)移診斷準(zhǔn)確率，UE可作為診斷乳腺癌ALN轉(zhuǎn)移的有臨床價(jià)值的新方法。
[Abstract]:Objective: to evaluate the diagnostic value of ultrasound elastography (ultrasonic elastography,UE) and two-dimensional ultrasound (Two-dimensional ultrasound,2D-US) in axillary lymph node (Axillary lymphnode,ALN) metastasis of breast cancer. Methods: from December 2012 to December 2013, 94 female breast cancer patients were admitted to the first affiliated Hospital of Guangxi Medical University and underwent surgical treatment. 2D-US and UE were performed on ipsilateral ALN94 of breast cancer. The characteristics of sonogram were observed, the cortical thickness was measured and the aspect ratio (Long diameter/short diameter ratio, L / S) was calculated. To evaluate the diagnostic value of ultrasound in ipsilateral ALN metastasis of breast cancer patients. Results: the ipsilateral metastatic ALN of 1.2D-US breast cancer was: lymph node L / S < 2.0, cortical thickening 鈮

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