超声对乳腺癌腋窝淋巴结的诊断价值

目的 探讨超声在致密型乳腺疾病中的诊断价值.方法 回顾性分析115例致密型乳腺患者和304例非致密型乳腺患者的超声声像图表现,并与其钼靶X线检查结果和病理结果相比较,统计分析超声对致密型乳腺疾病的检出率和诊断准确率.结果 超声对致密型、非致密型乳腺中的病灶检出率分别为96.3%、98.3%,均显著高于钼靶(36.0%、83.7%;P＜0.01).在致密型乳腺患者中,超声对乳腺癌的诊断敏感度显著高于钼靶(83.9%、51.6%;P＜0.01),但超声对乳腺癌的诊断特异度低于钼靶(88.6%、98.1%;P＜0.01),两者对于乳腺癌的诊断准确度均为87.5%.超声和钼靶对于非致密型乳腺的乳腺癌诊断敏感度、特异度、准确度差异均无统计学意义(P＞0.05).结论 乳腺超声显著提高了致密型腺体中病灶的检出率和乳腺癌的诊断敏感度,是致密型乳腺患者重要补充检查手段.

Ultrasonography in the preoperative evaluation of axillary lymph nodes in the patients with breast cancer

Objective To evaluate the value of ultrasonography in diagnosis of axillary lymph node metastasis in breast cancer. Methods The axillary lymph nodes in 164 patients with breast cancer were performed by uhraonography. The location, size, shape, internal echo, lymph hilum, corticomedullary structure and flow pattern of lymph node were explored. Results The detection rate of axillary lymph nodes was 73.2%. The detection rates of axillary lymph nodes of group Ⅰ to group Ⅲ were 61.1% , 21.3% and 18.1% , respectively. There were significant differences in the shape, internal echoes, lymph hilum, corti- comedullary structure and flow pattern between malignant and benign axillary lymph nodes. The round or fused shape, internal hypoehcoeity, hilar disappearance, vague corticomedullary structure and abundant flow were mainly observed in metastatic lymph nodes, and the diagnostic accuracy for metastatic lymph nodes were 97.5%, 95.8% , 89.2%, 85.8% and 65.0% , respectively. Conclusion Uhrasonography is an effective method to evaluate the status of axillary lymph nodes before operation, which could provide important reference value for clinical treatment and prognosis of the patient with breast cancer.