Yang W T, Chang J, Metreweli C
Department of Diagnostic Radiology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, USA.
Radiology. 2000 May;215(2):568-73. doi: 10.1148/radiology.215.2.r00ap20568.
To document differences in color Doppler flow and gray-scale ultrasonographic (US) features between benign and malignant axillary lymph nodes in women with primary breast cancer.
The longitudinal-transverse axis ratio and hilar status on color Doppler flow and gray-scale US images were prospectively studied for each of 145 axillary nodes in 135 women (74 palpable nodes in 69 women, 71 nonpalpable nodes in 66 women) with primary breast cancer. Intranodal flow distribution was described as peripheral, central, or central perhilar. Resistive and pulsatility indexes and peak systolic velocity were documented. For comparison of benign and malignant features, nodes were divided into three groups: palpable and nonpalpable, palpable, and nonpalpable.
Color flow was demonstrated equally well in benign and malignant axillary lymph nodes for all three groups. For all nodes, peripheral flow was significantly higher in malignant (118 of 153 nodes [77%]) than benign (45 of 160 nodes [28%]) nodes (P <.001); central flow and central perhilar flow were significantly greater (P <.002 and <.001, respectively) in benign than malignant nodes. Similar differences were not observed in nonpalpable nodes. The mean longitudinal-transverse axis ratio (+/- SD) was significantly lower in malignant (1.8 +/- 0.6) than benign (2.6 +/- 0.8) nodes. Logistic regression analysis showed peripheral, central, and central perhilar flow and the mean longitudinal-transverse axis ratio to be significant independent predictors of malignancy.
Color Doppler flow and gray-scale US features applicable to the identification of disease in palpable axillary nodes in patients with breast cancer are not applicable to nonpalpable nodes.
记录原发性乳腺癌女性患者良性和恶性腋窝淋巴结在彩色多普勒血流及灰阶超声（US）特征上的差异。
前瞻性研究了135例原发性乳腺癌女性患者的145个腋窝淋巴结（69例女性中的74个可触及淋巴结，66例女性中的71个不可触及淋巴结）的彩色多普勒血流及灰阶US图像上的纵横轴比和门部情况。将结内血流分布描述为周边型、中央型或中央门周型。记录阻力指数、搏动指数和收缩期峰值流速。为比较良性和恶性特征，将淋巴结分为三组：可触及和不可触及组、可触及组和不可触及组。
三组中良性和恶性腋窝淋巴结的彩色血流显示效果相当。对于所有淋巴结，恶性淋巴结（153个中的118个[77%]）的周边血流显著高于良性淋巴结（160个中的45个[28%]）（P<.001）；良性淋巴结的中央血流和中央门周血流显著多于恶性淋巴结（分别为P<.002和<.001）。在不可触及的淋巴结中未观察到类似差异。恶性淋巴结的平均纵横轴比（±标准差）（1.8±0.6）显著低于良性淋巴结（2.6±0.8）。逻辑回归分析显示周边、中央和中央门周血流以及平均纵横轴比是恶性肿瘤的重要独立预测指标。
适用于识别乳腺癌患者可触及腋窝淋巴结疾病的彩色多普勒血流及灰阶US特征不适用于不可触及的淋巴结。
