经皮下注射超声造影剂在乳腺肿块前哨淋巴结检测中的应用价值

目的 探讨经皮下注射超声造影剂(SonoVue)在检测乳腺癌患者前哨淋巴结(SLN)中的应用价值.方法 对常规超声检出的42例乳腺肿块患者经皮下肿块边缘3、6、9、12点各注射1.25 m1SonoVue,观察同侧腋窝SLN的造影增强情况,记录淋巴管开始增强时间、增强淋巴结个数、部位、淋巴结开始增强时间、消退时间.并与美兰染色及病理对照,比较造影对SLN检出的准确性.结果 42例乳腺肿块患者术前超声造影成功检出SLN 30例,检出率71.4%.良性肿块10例,检出SLN 5例,检出率50%;乳腺癌32例,检出SLN 25例,检出率78.1%;共检出SLN 40枚,良性5枚,乳腺癌转移淋巴结35枚.美兰染色后检出SLN 39例,检出率92.9%,其中良性肿块10例,检出SLN 7例;乳腺癌32例,美兰全部染色.共检出SLN 64枚,良性11枚,乳腺癌转移淋巴结53枚.结论 经皮下注射SonoVue可较好地检测出SLN,在预测乳腺癌淋巴结是否转移中有一定的应用价值.

Proto-explore of ultrasound contrast agents injected subcutaneously for enhancement in sentinel lymph nodes of breast masses

Objective To discuss application value for detecting sentinel lymphatic node(SLN) in patients with breast mass by subcutaneous injection SonoVue. Methods Forty-two cases with breast masses who were detected by conventional techniques were injected subcutaneously with 1.25 ml Sono Vue to the borderline of breast tumor at each 3,6,9, 12 points. The changes of contrast-enhanced ultrasound (CEUS) of the ipsilateral axillary SLN were observed and the start time of enhancement of lymphatic channel and lymph nodes, the position and numbers of enhancement of the lymph nodes, the time of regression were recorded. Compared with Methylene blue and surgicalbiopsy, the accuracy of detection of SLN by CEUS were evaluated. Results SLN were successfully detected in 30 of 42 patients, the detection rate was 71.4%. The total number of detected SLN was 40.Five nodes were detected in 5 of 10 (50%)patients with benign masses. Thirty-five nodes were detected in 25 of 32 (78.1%) patients with breast cancer. Fifty-seven SLN were successfully detected in 39 of 42 patients with Methylene blue, the accurate rate was 92.9%. Seven of 10 patients with benign masses and all 32 patients with breast cancer were Methylene blue positive. There were total 64 SLN found, including 11 with benign masses and 53 with lymph nodes metastasis of breast cancer cells. Conclusions The subcutaneous injection SonoVue is effective to detect SLN in patients with breast mass and apply clinical value for forecasting whether the lymph node metastases in patients with breast cancer.