Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
J Ultrasound Med. 2011 Apr;30(4):441-53. doi: 10.7863/jum.2011.30.4.441.
The purpose of this study was to compare lymphosonography (ie, contrast-enhanced ultrasound imaging [US] after interstitial injection of a US contrast agent) for the detection of sentinel lymph nodes (SLNs) in swine with naturally occurring melanoma tumors to lymphoscintigraphy using blue dye-guided surgical dissection as the reference standard. Also, we sought to determine if lymphosonography can be used to characterize SLNs.
Sixty-three swine with 104 melanomas were evaluated. Contrast-specific US was performed after peritumoral injection (1 mL dose) of Sonazoid (GE Healthcare, Oslo, Norway). Lymphoscintigraphy was performed after peritumoral injections of technetium Tc 99m sulfur colloid. Peritumoral injection of 1% Lymphazurin (Ben Venue Labs, Inc, Bedford, OH) was used to guide SLN resection. The accuracy of SLN detection with the two imaging modalities was compared using the McNemar test. The SLNs were qualitatively and quantitatively characterized as benign or malignant based on the lymphosonography results with histopathology and RNA analyses used as the reference standards.
Blue dye-guided surgery identified 351 SLNs. Lymphosonography detected 293 SLNs and 11 false-positives, while lymphoscintigraphy detected 231 SLNs and 20 false-positives. The accuracy of SLN detection was 81.8% for lymphosonography, which was significantly higher than the 63.2% achieved with lymphoscintigraphy (P < .0001). The accuracy of lymphosonography for SLN characterization was 80%. When the size of the enhanced SLN was taken into consideration to characterize SLNs, the accuracy was 86%.
Lymphosonography is statistically better than lymphoscintigraphy for the detection of SLNs in this animal model. The ability to use lymphosonography as a means to characterize SLNs as benign or malignant is limited.
本研究旨在比较淋巴超声造影（即间质注射超声造影剂后对比增强超声成像）检测猪自然发生黑素瘤肿瘤的前哨淋巴结（SLN）与蓝染引导手术解剖的淋巴闪烁显像的效果，并确定淋巴超声造影是否可用于对 SLN 进行特征描述。
对 63 头有 104 个黑素瘤的猪进行了评估。在肿瘤周围注射（1 mL 剂量）声诺维（GE Healthcare，奥斯陆，挪威）后进行对比特异性超声检查。在肿瘤周围注射锝 99m 硫胶体后进行淋巴闪烁显像。在肿瘤周围注射 1%淋巴紫（Ben Venue Labs，Inc，俄亥俄州贝德福德）引导 SLN 切除。使用 McNemar 检验比较两种成像方式检测 SLN 的准确性。根据淋巴超声造影结果，结合组织病理学和 RNA 分析作为参考标准，对 SLN 进行定性和定量特征描述。
蓝染引导手术确定了 351 个 SLN。淋巴超声造影检测到 293 个 SLN 和 11 个假阳性，而淋巴闪烁显像检测到 231 个 SLN 和 20 个假阳性。淋巴超声造影检测 SLN 的准确率为 81.8%，明显高于淋巴闪烁显像的 63.2%（P <.0001）。淋巴超声造影对 SLN 特征描述的准确率为 80%。当考虑增强 SLN 的大小对 SLN 进行特征描述时，准确率为 86%。
在该动物模型中，淋巴超声造影在检测 SLN 方面的统计结果优于淋巴闪烁显像。淋巴超声造影作为一种将 SLN 特征描述为良性或恶性的方法，其能力有限。
