乳腺癌腋窝淋巴结转移的超声特征与病理对比分析研究.pdfVIP

哈尔滨医科大学硕士论文 摘 要 目的 评价二维超声、彩色多普勒血流显像及脉冲多普勒特征结合病理表现诊 断乳癌腋窝淋巴结转移的临床应用价值。 材料与方法 所用仪器为东芝SSA-270A及SSA-370A型彩色多普勒显像仪， 探头频率为7.5--13MHz线阵。我们观察分析了68例乳腺癌患者，76个腋窝淋巴 结 (26个良胜，50个转移性)。所有病例均经手术病理证实。 结果 在淋巴结诸多参数中，边缘型血流分布模式、US1.5及髓质回声消失 是诊断乳癌淋巴结转移的单项指标。单独依据边缘型血流分布模式、US1.5 及髓质回声消失诊断转移性淋巴结的敏感性分别为80.5%,74.0%,72.0%;特异 性分别为80.0%,73.1%,65.4%;准确性分别为80.3%,73.7%,69.7%。三项指 标联合诊断的敏感性为63.4%，特异性为85.0%，准确性为70.5%a 结论 在乳癌腋窝淋巴结性质的鉴别诊断中，血流分布模式、纵横比及髓质回 声特征是单项预测指标，三者联合具有较高特异性。此结果对临床乳癌的分期和 治疗有较大的实用价值。 主题词 腋窝淋巴结转移:乳癌;彩色多普勒血流显像:脉冲多普勒:病理 哈尔滨医科大学硕士论文 UltrasonographicAppearanceofAxillaryMetastaticLymph NodesinBreastCarcinomaandContrastStudyonPathology ABSTRACT ObjectiveThepurposeofthisstudywastoevaluatetheclinicalapplicablevalue ofgray-scaleultrasound、colorDopplerflow imagingandpulsedDoppler echographywithpathologyindiagnosisaxillarymetastatic nodesinbreast cancer ， MaterailsandMethods Allexaminationswereconductedwithmodel TOSHIBASSA-270AandSSA-370AUSscannerbyusing7.5-13MHZliner-array probers.76axillarylymphnodes(26benign，50metastatic)obtainedfrom68breast cancerpatientswereevaluated.Finaldiagnosisofallpatientswasestablishedby pathologyafteroperation. ResultsAllparametersoflymphnodes,peripheraldistributionofvascularflow, L/S-1.5orabsenceofhilumweresignificantindependentpredictorsofaxillary metastaticlymphnodes.Withsignalindex,suchasperipheralflow,L/S-1.5or absenceofhilum,thesensitivitywere80.5%,74.0%,72.4% respectively;the specificitywere80.0%,73.1%,65.4% respectively;andtheaccuracywere 80.3%,73.70/x,69.7%respectively.Thisthreeunitedindexmadethesensitivity、 specificityandaccuracywere63.4%,85.0%and70.5%. Conclusion Thepatternofvascularity、L/Sandhilummorphologywere significantindependentpredictorsofaxillarymetastaticlymphnodesinbreast cancer,andfurthermore,unitedthreeindexsmadethehigherspecificity.These promisingfindingsmayhave