Li Ling, Zhao Jing, Li Fangxuan, Pan Zhanyu
Department of Integrated Traditional and Western Medicine, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China.
Department of Ultrasound Diagnosis and Treatment, Tianjin Medical University Cancer Institute & Hospital, Tianjin, People's Republic of China.
Cancer Manag Res. 2024 Nov 29;16:1685-1692. doi: 10.2147/CMAR.S482484. eCollection 2024.
This study aimed to compare the diagnostic accuracy of ultrasound (US) and magnetic resonance imaging (MRI) in evaluating axillary lymph nodes (ALNs) status in breast cancer patients.
We retrospectively analyzed 590 female breast cancer patients who had undergone both ultrasound and MRI to assess ALNs prior to any invasive procedures. Using pathological results as the standard, we compared the diagnostic performance of the two imaging modalities.
For differentiating between malignancy and benign ALNs, the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound were 68.98%, 38.14%, 86.67%, 62.12% and 70.96%, respectively. MRI demonstrated corresponding values of 72.03%, 38.60%, 91.20%, 71.55% and 72.15%. In assessing the burden status of ALNs (high vs low), ultrasound yielded values of 78.47%, 52.75%, 83.17%, 36.36% and 90.61%, while MRI showed corresponding values of 81.19%, 52.75%, 86.37%, 41.38% and 90.93%. There were no statistically significant differences between the two imaging modalities in their ability to evaluate ALN malignancy or burden status.
Both ultrasound and MRI offer comparable value in assessing ALN status. Whether evaluating for metastatic involvement or determining ALN burden, it may not be necessary for patients to undergo both imaging tests.
本研究旨在比较超声（US）和磁共振成像（MRI）在评估乳腺癌患者腋窝淋巴结（ALNs）状态时的诊断准确性。
我们回顾性分析了590例在接受任何侵入性手术前均接受过超声和MRI检查以评估腋窝淋巴结的女性乳腺癌患者。以病理结果作为标准，我们比较了两种成像方式的诊断性能。
在区分腋窝淋巴结恶性和良性方面，超声的诊断准确性、敏感性、特异性、阳性预测值和阴性预测值分别为68.98%、38.14%、86.67%、62.12%和70.96%。MRI的相应值分别为72.03%、38.60%、91.20%、71.55%和72.15%。在评估腋窝淋巴结的负荷状态（高负荷与低负荷）时，超声得出的值分别为78.47%、52.75%、83.17%、36.36%和90.61%；而MRI的相应值分别为81.19%、52.75%、86.37%、41.38%和90.93%。在评估腋窝淋巴结恶性或负荷状态方面，两种成像方式的能力没有统计学上显著差异。
超声和MRI在评估腋窝淋巴结状态方面具有相当的价值。无论是评估转移累及情况还是确定腋窝淋巴结负荷，患者可能无需同时接受两种成像检查。
