兔VX2肿瘤引流淋巴结经静脉超声造影与病理对照研究

目的 探讨经静脉超声造影判断兔VX2肿瘤引流淋巴结转移与否的准确性,及良性增生性病变对淋巴结造影显影的影响.方法 建立兔VX2乳腺癌模型30只,筛选32个腋窝区引流淋巴结行超声造影,记录淋巴结造影前后的声学密度值,计算差值;并结合视觉评分将淋巴结造影增强程度分为4级,解剖出淋巴结,光镜观察其有无转移灶,有无滤泡增生、淋巴窦扩张等良性增生性病变及其程度;分析淋巴结显影与肿瘤转移良性增生性病变有无关系.结果 32个淋巴结进行超声造影,病理证实良性增生淋巴结组25个,肿瘤转移淋巴结组7个.两组淋巴结造影前后声学密度值比较,差异无统计学意义.四种良性病变在造影Ⅰ级的淋巴结病变较轻微,造影Ⅲ级的淋巴结病变较严重,但具体每一种增生性病变在造影分级间均无统计学差异.结论 单独分析造影前后兔VX2肿瘤引流淋巴结增强程度的变化尚不能准确判断肿瘤引流淋巴结的良恶性,但其可在一定程度上反映淋巴结良性增生性病变的程度.

Comparative study of intravenous contrast-enhanced ultrasonography and pathology in rabbit VX2 tumor draining lymph nodes

Objective To explore the accuracy of judging rabbit VX2 tumor draining lymph nodes metastases by intravenous contrast-enhanced ultrasonography （CEUS） and the influence of benign proliferative lesions on lymph node CEUS. Methods Thirty New Zealand rabbits bearing VX2 breast cancer were enrolled in this study. 32 draining lymph nodes in axillary area were proceed by intravenous CEUS. A classification of lymph nodes enhancement was established by combining visual score and acoustic density quantification. The lymph node specimens were finally harvested for pathological examination including tumor metastasis and benign proliferative lesions. The relationship between benign lesions and lymph nodes enhancement was analyzed. Results 32 draining lymph nodes were imaged by intravenous CEUS. Pathological record showed that tumor metastases were confirmed in 7 lesions and benign proliferative lymph nodes were confirmed in 25 lesions. There was no significant difference on the acoustic density of benign lymph nodes and metastatic lymph nodes. Among four kinds of benign lesions, lymph node lesions of grade I enhancement were relatively mild, while lymph node lesions of grade III enhancement were more serious. There were no significant differences among the grades of lymph nodes enhancement. Conclusion Enhancement grades in rabbit VX2 tumor draining lymph nodes by intravenous CEUS could still not accurately determine the benign and malignant of tumor draining lymph nodes, but to a certain extent reflect the degree of benign proliferative lesions in lymph nodes.