SonoVue及Sonazoid在早期乳腺癌患者前哨淋巴结定位中的初步研究

目的探讨SonoVue及Sonazoid在早期乳腺癌患者前哨淋巴结（SLN）定位中的应用。 方法纳入2018年1月1日至2020年1月30日于北京大学第三医院就诊的临床诊断为乳腺癌T1~2期的患者204例。所有患者均行腋窝淋巴结清扫术或SLN活检术取得病理结果，术前均行超声造影检查。依据超声造影剂选用类型的不同，将204例患者分为SonoVue组135例（男性1例），Sonazoid组69例。观察2组SLN显影的数量、持续时间等，并分别与美蓝染色方法进行对比分析。 结果SonoVue组135例患者，超声造影检出SLN共210个，美蓝染色检出297个，差异有统计学意义（t=6.964，P＜0.001）；Sonazoid组69例患者，超声造影检出SLN共102个，美蓝染色检出139个，差异有统计学意义（t=3.763，P＜0.001）。SonoVue组135例患者中1例造影定位未成功，美蓝染色定位显影失败4例；Sonazoid组68例患者全部成功定位，美蓝染色定位显影失败3例，2组显影成功率分别与美蓝染色比较，差异均无统计学意义（P=0.370、0.244）。SonoVue组与Sonazoid组之间的显影成功率比较（99.3% vs 100.0%），差异无统计学意义（P＞0.05）。造影剂注射后60、120 min时，SonoVue组SLN内均未见淋巴结显影，而Sonazoid组切除的蓝染淋巴结在生理盐水中均持续显影。 结论Sonazoid在定位早期乳腺癌患者SLN中的应用价值不低于SonoVue，其在SLN中持续显影的特性有望用于术中检验切除SLN的准确性及完整性。

Comparison of Sono Vue and Sonazoid in localization of sentinel lymph nodes in early breast cancer patients

Objective To compare the application of SonoVue and Sonazoid in the localization of sentinel lymph nodes(SLN)in early breast cancer patients.Methods A total of 204 patients with T1-2 breast cancer diagnosed at Peking University Third Hospital from January 1,2018 to January 30,2020 were included.All patients underwent axillary lymph node dissection or sentinel lymph node biopsy to obtain the pathological results,and all patients underwent contrast-enhanced ultrasound examination before operation.According to the type of contrast agent used,the patients were divided into either a SonoVue group(135 cases,including 1 male case)or a Sonazoid group(69 cases).The number and time of enhancement of SLN in the two groups were observed,and the two contrast agents were then compared with methylene blue staining.Results Among the 135 patients in the SonoVue group,210 SLNs were detected by CEUS and297 by methylene blue staining,and the difference was statistically significant(t=6.964,P=0.000);among 69 patients in the Sonazoid group,102 SLNs were detected by CEUS and 139 by methylene blue staining,and the difference was also statistically significant(t=3.763,P=0.000).Among the 135 patients in the SonoVue group,1 failed in angiography localization,and 4 failed in methylene blue staining localization;all the 68 patients in the Sonazoid group all succeeded in localization,but 3 cases failed in methylene blue staining localization,with no significant difference(P=0.370,0.244).The success rate of enhancement between in the SonoVue and Sonazoid groups was 99.3%vs 100%,and the difference was not statistically significant(P>0.05).There was no SLN enhancement in the SonoVue group at 60 and 120 min after injection of the contrast medium.The blue stained lymph nodes in the Sonazoid group had continued enhancement in saline.Conclusion The diagnostic value of Sonazoid in sentinel lymph nodes in early breast cancer patients is not lower than that of SonoVue,and its ability of continuous enhancement of SLN is expected to be used for intraoperative confirmation of the accuracy and completeness of SLN removal.