Three‐Dimensional Sonography of Axillary Lymph Nodes in Patients With Breast Cancer

Sonography is useful in the evaluation of axillary lymph nodes in patients with breast cancer. In this pictorial essay, we review the range of grayscale and Doppler appearances of abnormal axillary lymph nodes on 2‐dimensional and 3‐dimensional imaging.     

Dynamic Visualization of Lymphatic Channels and Sentinel Lymph Nodes Using Intradermal Microbubbles and Contrast‐Enhanced Ultrasound in a Swine Model and Patients With Breast Cancer

Objective. Sentinel lymph node (SLN) identification using intradermal micro‐bubbles and contrast‐enhanced ultrasound (CEUS) has been recently reported in swine models and patients with breast cancer. The objective of this study was to investigate the dynamics of intradermally administered microbubbles as they travel to draining SLNs in pigs. We also performed a detailed study of the passage of microbubbles through breast lymphatic channels in a small group of patients with breast cancer. Methods. Nine anesthetized healthy pigs were used for the study, and 5 female patients with primary breast cancer were recruited. Pigs received intradermal injections of a microbubble contrast agent in several territories to access lymphatic drainage to regional lymph nodes. Patients had periareolar intradermal injection of the microbubble contrast agent. Ultrasound examination was performed in the real‐time contrast pulse sequencing mode with a commercial scanner. Results. Sentinel lymph nodes were identified rapidly (<1 minute) and consistently in pigs. Intradermal microbubble injection and CEUS were found to have perfect concordance with the Evans blue dye method in locating swine SLNs. In all 5 patients with breast cancer, the microbubble contrast agent entered breast lymphatic channels and traveled to draining ipsilateral axillary SLNs within 3 minutes. Conclusions. Intradermally injected microbubbles traverse readily though lymphatic channels in pigs and human breast tissue. The ability to rapidly identify SLNs in the diagnostic period would enable targeted biopsy and may facilitate preoperative axillary staging in patients with early breast cancer.     

Bedside Contrast‐Enhanced Sonography of Critically Ill Patients

The transfer of critically ill patients to the radiology department is, in itself, potentially dangerous, so radiologists are frequently asked to perform bedside sonographic studies in the intensive care unit, surgical or medical department, sterile area, and operating room. In these circumstances, injection of a contrast agent may give the radiologist relevant additional information, which is useful for diagnosis and for better therapeutic management of these critically ill patients. Contrast‐enhanced sonography may allow detection of findings not recognizable on baseline sonography or even color Doppler imaging. In this pictorial essay, we highlight the value of real‐time contrast‐enhanced sonography when performed at the bedside in critically ill patients.     

乳腺癌保乳术中腋窝淋巴结清扫方法的改进研究

目的:比较乳腔镜与传统手术方法在乳腺癌保乳术中腋窝淋巴结清扫的效果.方法:111例乳腺癌患者均施行保乳术,以应用乳腔镜和传统腋窝淋巴结清扫术为研究组(n＝63)和对照组(n＝48);比较两组间手术时间、术中出血量、清扫淋巴结数量、术后引流量、引流时间、手术并发症等.结果:研究组的术中出血量、术后引流量、引流时间、手术并发症均明显少于对照组,P＜0.05;研究组的手术时间、清扫淋巴结数量与对照组无明显差异,P＞0.05.结论:乳腺癌保乳术应用乳腔镜腋窝淋巴结清扫较传统手术创伤小、并发症少、术后恢复快,值得推广.     

乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的方法及临床意义

目的 探讨乳腺癌改良根治术、保乳手术及乳腔镜手术行腋窝淋巴结清扫时保留肋间臂神经（ICBN）的方法及临床意义.方法 2006年1月～2009年1月实施腋窝淋巴结清扫术（包括改良根治术、保乳手术及乳腔镜手术）的Ⅰ、Ⅱ、Ⅲa期乳腺癌患者,分为保留肋间臂神经组及未保留肋间臂神经组,评价两组患者术后患侧腋窝和上臂内侧区域的皮肤感觉功能,并对两组中实施改良根治术、保乳手术及乳腔镜手术的病例分别进行统计分析.结果 保留ICBN组患侧腋窝及上臂内侧皮肤感觉异常发生率（30.8%）明显低于未保留ICBN组（78.2%）.结论 乳腺癌手术行腋窝淋巴结清扫时保留肋间臂神经可以明最减少术后患侧腋窝及上臂内侧感觉障碍,提高患者术后生活质量.