Surgery, Community Hospital Reutte, Austria.
Ultraschall Med. 2010 Feb;31(1):63-7. doi: 10.1055/s-0028-1109847. Epub 2010 Jan 21.
We assessed the value of contrast-enhanced US for differentiating between benign and malignant axillary lymph nodes in breast cancer.
A total of 120 axillary lymph nodes in 92 patients with breast cancer were studied. All patients underwent grayscale US examination, unenhanced and enhanced color and power Doppler US, and enhanced grayscale harmonic US examination.
The mean size of the 120 axillary lymph nodes was 1.5 cm (range 0.5 - 3.4 cm). Of all 120 axillary lymph nodes studied, 80 (67 %) were malignant and 40 (33 %) were benign according to pathological examination. The total number of vessels in baseline US did not increase between benign and malignant lymph nodes (3.3 +/- 2.2 vs. 5.4 +/- 4.0; p > 0.05). The total number of peripheral vessels was 0.5 +/- 0.8 for benign lymph nodes vs. 2.0 +/- 1.7 for malignant lymph nodes (p > 0.05). Enhanced US studies showed enhancement in both benign and malignant lymph nodes after contrast administration with a significantly higher degree of enhancement in malignant lymph nodes (p < 0.01). The total number of vessels was significantly higher in malignant lymph nodes after contrast administration (17.3 +/- 8.0 vs. 8.2 +/- 5.1, p < 0.01). Malignant lymph nodes demonstrated longer contrast enhancement duration compared to benign lymph nodes.
This preliminary data shows that contrast-enhanced US can differentiate between benign and malignant lymph nodes in breast cancer.
我们评估了超声造影在鉴别乳腺癌腋窝良恶性淋巴结中的价值。
共对 92 例乳腺癌患者的 120 个腋窝淋巴结进行了研究。所有患者均行灰阶超声、灰阶超声联合彩色及能量多普勒、超声造影检查。
120 个腋窝淋巴结的平均大小为 1.5cm（范围：0.5～3.4cm）。所有患者中，根据病理检查结果，120 个腋窝淋巴结中良性 40 个（33%），恶性 80 个（67%）。基础灰阶超声下，良性和恶性淋巴结的血管总数（3.3±2.2 比 5.4±4.0；p＞0.05）、周边血管总数（良性淋巴结 0.5±0.8 比恶性淋巴结 2.0±1.7；p＞0.05）均无明显差异。超声造影显示，良性和恶性淋巴结均有增强，且恶性淋巴结的增强程度明显更高（p＜0.01）。造影后，恶性淋巴结的血管总数明显高于良性淋巴结（17.3±8.0 比 8.2±5.1；p＜0.01）。与良性淋巴结相比，恶性淋巴结的造影增强持续时间更长。
初步数据表明，超声造影可鉴别乳腺癌腋窝良恶性淋巴结。
