超声造影预测乳腺癌腋窝淋巴结转移的多因素分析

目的分析腋窝淋巴结和乳腺癌原发灶的常规超声及CEUS表现,探讨其与腋窝淋巴结转移的相关性。方法回顾性分析41例乳腺癌患者的腋窝淋巴结及其乳腺原发灶的常规超声及CEUS资料,观察腋窝淋巴结及乳腺原发灶的大小、形态、纵横比、淋巴结皮质厚度、血流分级、造影灌注顺序、增强模式、径线扩大、周边放射状血管增强及造影各参数等。经单因素和Logistic多因素回归分析,检验上述指标与腋窝淋巴结转移的相关性。结果单因素分析显示淋巴结纵横比、淋巴结最大皮质厚度、淋巴结血流分级、淋巴结周边声晕、淋巴结灌注顺序、淋巴结增强方式、淋巴结径线扩大、淋巴结边缘增强及乳腺癌原发灶相对曲线下面积差等与淋巴结转移相关,差异有统计学意义(P<0.05);多因素分析结果显示淋巴结增强方式、造影后淋巴结径线扩大与淋巴结转移相关,差异有统计学意义(P<0.05)。结论通过腋窝淋巴结的CEUS指标可准确预测淋巴结的转移情况,对临床有重要指导作用。

Multiple factors analysis for predicting lymph node metastasis of breast cancer with CEUS

Objective To explore the relationship among axillary's lymph node metastasis and the conventional ultrasound (US) and CEUS imaging of breast tumor or axillary's lymph nodes. Methods US and CEUS images of 41 patients with breast cancer and axillary's lymph nodes were retrospectively analyzed, including tumor size, morphology, aspect ratio, cortical thickness of lymph node, blood flow grades, perfusion imaging sequence, enhanced pattern, diameter enlarged, enhanced peripheral, as well as various parameter of CEUS. By single factor and multiple factors Logistic regression analysis, relationship about the above indexes and lymph node metastasis were analyzed. Results Single factor analysis showed breast tumor relative area difference under curve (AUC), aspect ratio, cortical thickness, blood flow grades, perfusion imaging sequence, peripheral echo halo, enhanced pattern, diameter enlarged, enhanced peripheral of lymph node were related with lymph node metastasis. And multiple factors analysis showed enhanced pattern, diameter enlarged of lymph node were related with lymph node metastasis. Conclusion Analysis on CEUS characteristics of axillary's lymph node is accurate in predicting lymph node metastasis, therefore having important guiding role in clinic application.