上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

实时组织弹性成像在乳腺癌腋窝淋巴结鉴别诊断中的应用

俞 理，胡 兵，林燕苹，王富文，胡 滨   

  1. 上海交通大学附属第六人民医院超声医学科 上海超声医学研究所， 上海 200233
  • 出版日期:2014-10-28 发布日期:2014-10-28
  • 作者简介:俞 理（1982—）， 女， 住院医师， 硕士; 电子信箱: yuli0122@126.com。

Application of real-time tissue elastography in differential diagnosis of axillary lymph nodes of patients with breast cancer

YU Li, HU Bing, LIN Yan-ping, WANG Fu-wen, HU Bin   

  1. Department of Ultrasound in Medicine, Shanghai Institute of Ultrasound in Medicine， the Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233， China
  • Online:2014-10-28 Published:2014-10-28

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摘要：

目的 探讨实时组织弹性成像（RTE）在乳腺癌腋窝淋巴结鉴别诊断中的价值。方法 对69枚乳腺癌患者的腋窝淋巴结进行灰阶超声及RTE检查。灰阶超声及RTE评分方法为5分法，RTE评分感兴趣区为淋巴结内低回声部分，联合评分为灰阶超声及RTE评分的总分，并测量弹性应变率（SR）。以淋巴结穿刺活检病理结果作为对照。结果 根据ROC曲线灰阶超声及RTE评分诊断界值为3分，联合评分为6分，SR为2.28。灰阶超声的敏感性、特异性和诊断符合率分别为89.74%、76.67%和84.06%；RTE为84.61%、90.00%和87.96%；联合评分为92.31%、93.33%和92.75%，SR为94.87%、83.33%和89.86%。结论 RTE可作为灰阶超声的补充手段应用于乳腺癌腋窝淋巴结的鉴别诊断。

关键词: 超声, 实时组织弹性成像, 乳腺癌, 腋窝淋巴结转移

Abstract:

Objective To evaluate the value of real-time tissue elastography (RTE) for the differential diagnosis of axillary lymph nodes of patients with breast cancer. Methods Sixty-nine axillary lymph nodes of patients with breast cancer underwent grey-scale ultrasound and RTE. The grey-scale sonograms and elastograms were scored from 1 to 5. The region of interest of elastogram scoring is the hypoechoic region in the lymph nodes. The combined score was the sum of both grey-scale and elastogram scores. The strain ratio (SR) index was also measured. Results of RTE were compared to the pathological results of the lymph node core biopsy. Results According to the ROC curve, the diagnostic cutoff value of grey-scale ultrasound and RTE scores was 3; combined evaluation was 6; and SR was 2.28. Sensitivity, specificity, and diagnostic accuracy of grey-scale sonography were 89.74%, 76.67%, and 84.06% and those of RTE were 84.61%, 90.00% and 87.96%. Sensitivity, specificity, and diagnostic accuracy of combined evaluation were 92.31%, 93.33% and 92.75%, and those of SR were 94.87%, 83.33% and 89.86%. Conclusion RTE is a complementary method of the grey-scale ultrasound for the differential diagnosis of axillary lymph nodes of patients with breast cancer.

Key words: ultrasound, real-time tissue elastography, breast cancer, axillary lymph node metastasis