| 摘要: |
| 目的 探讨剪切波弹性成像预测乳腺癌同侧腋窝前哨淋巴结转移的临床价值。方法 选取我院经病理证实为乳腺癌的患者70例，对患侧行经皮前哨淋巴结超声造影，于体表标记引流淋巴管及淋巴结的位置，然后对该淋巴结进行SWE评估，记录声像图类型和弹性模量最大值、最小值、平均值、弥散度（Emax、Emin、Emean、SD）（补中文名称）。以病理结果为金标准，绘制受试者工作特征曲线，分析SWE特征性声像图在诊断前哨淋巴结转移的诊断效能。结果 转移组Emax、Emean、SD均大于非转移组，差异均有统计学意义（均P＜0.05），Emin小于非转移组，但差异无统计学意义。SWE表现有“硬环征”、“多彩征”、“充盈缺损”的Ⅱ、Ⅲ、Ⅳ型淋巴结为转移性前哨淋巴结的风险大，与病理结果的诊断一致性较好（Kappa值=0.798）。ROC曲线分析结果显示，SWE定性分型ROC的风险截断值＞1，考虑Ⅱ、Ⅲ、Ⅳ型为转移性淋巴结，其诊断敏感性、特异性、阳性预测值、阴性预测值、曲线下面积分别为81.8%、97.3%、96.4%、85.7%和0.902，均高于硬度定量的诊断效能。结论 应用SWE可以实时、便捷、无侵入性地定性分析乳腺癌患者前哨淋巴结的图像特点，定量获取前哨淋巴结的硬度信息，为前哨淋巴结性质的鉴别提供新的检测方法。的有效检出。 |
| 关键词: 剪切波弹性成像 定性评估 乳腺癌 超声造影 前哨淋巴结 |
| DOI： |
| 投稿时间：2020-11-03修订日期：2021-08-20 |
| 基金项目:四川省科技厅应用基础项目(2019YJ0708) |
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| Clinical value of Shear Wave Elastography in predicting axillary sentinel lymph node metastasis in breast cancer |
| Chen Sisi,Yue Wensheng,Yu Lili,Huang Xinru,Tan xueyan |
| (North Sichuan Medical College) |
| Abstract: |
| Objective：To evaluate the clinical value of SWE in predicting ipsilateral axillary sentinel lymph node metastasis in breast cancer. Methods A total of 70 patients with breast cancer confirmed by pathology were enrolled in the Affiliated Hospital of North Sichuan Medical College. Percutaneous sentinel lymph node contrast-enhanced ultrasound （SLN-CEUS） was performed on the affected side，and the locations of drainage lymphatic vessels and lymph nodes were marked on the body surface。SWE was used to evaluate the lymph node, recording the type of ultrasonic image and elastic modulus（Emax、Emin、Emean、SD）。The ultrasonographic features of metastatic lymph nodes were analyzed based on the pathological results. Results: Emax，Emean and SD of metastatic lymph nodes were higher than those of non-metastatic lymph nodes （P < 0.05）.The cut-off value of ROC in SWE classification suggested that SLN with“Rim of stiffness”，“Colored lesion”，“Defect filling”（Type II,III,IV ）were at high risk of becoming metastatic SLN. It was of high clinical value to determine the nature of lymph nodes by qualitative classification of SWE, the Kappa value, AUC，sensitivity，specificity，PPV and NPV were 0.798，0.902，81.8%，97.3%，96.4%and85.7%,respectively.Conclusion: SWE had specific manifestations in metastatic SLN which can help to identify the nature of SLN.SWE was real-time，convenient and non-invasive. It can improve the detection of SLN metastasis effectively. |
| Key words: SWE Qualitative assessment breast cancer CEUS SLN |
