【摘要】 目的 探讨经皮注射淋巴结超声造影与常规超声对乳腺癌前哨淋巴结显像及转移的诊断价值。方法 对79例乳腺癌患者进行研究，以手术过程中的亚甲蓝染色作为对比，应用经皮注射冻干粉剂对这些患者的前哨淋巴结进行超声造影检查，同时与常规超声检查结果进行比较。结果 42例患者行超声造影检查，经过超声造影检查显示发现前哨淋巴结的患者29例(38枚淋巴结),前哨淋巴结19枚(病理15枚),非转移性淋巴结19枚(病理17枚),敏感性是83.3%,特异性是92.3%,准确性是93.1%。常规超声检查患者37例，发现淋巴结21枚，13枚前哨淋巴结(病理10枚),非转移性淋巴结8枚(病理6枚),敏感性是37.5%,特异性是42.9%,准确性是53.8%。超声造影对乳腺癌前哨淋巴结诊断的准确性、特异性和敏感性都有所提高，两者进行比较差异具有统计学意义(P<0.05)。结论 经皮注射淋巴结超声造影可以对前哨淋巴结进行较为准确的定位、定性，临床诊断价值优于常规超声检查。更多还原

【Abstract】 Objective To compare the diagnostic values of conventional ultrasound and contrast-enhanced ultrasound with percutaneous injection of contrast agents in the lymph nodes for the sentinel lymph nodes in breast cancer patients. Methods A total of 79 breast cancer patients who were admitted into our hospital from February 2013 to April 2015 were enrolled into the current study. They were percutaneously injected with lyophilized powders for ultrasound examination of the sentinel lymph nodes, with methylene blue as a contrast agent. Meanwhile, they were subjected to conventional ultrasound. Results Among 42 patients performing contrast-enhanced ultrasound were 29 patients with the sentinel lymph nodes(38 lymph nodes), including 19 sentinel lymph nodes(where 15 nodes were pathological diagnosed), and 19 non-metastatic lymph nodes(where 17 nodes were pathological diagnosed), achieving 83.3% sensitivity, 92.3% specificity and 93.1% accuracy. Meanwhile, 21 lymph nodes were found in 37 patients after conventional ultrasound, including 13 sentinel lymph nodes(where 10 nodes were pathological diagnosed), and 8 non-metastatic lymph nodes(where 6 nodes were pathological diagnosed), achieving 37.5% sensitivity, 42.9% specificity and 53.8% accuracy. Compared with conventional ultrasound, contrast-enhanced ultrasound could produce significant improvement in sensitivity, specificity and accuracy for diagnosis of the sentinel lymph nodes in breast cancer patients(P<0.05). Conclusion Contrast-enhanced ultrasound with percutaneous injection of contrast agents in the lymph nodes can well determine the sentinel lymph nodes in breast cancer patients, with superior clinical values to conventional ultrasound.更多还原