Dong Yijie, Liu Juan, Jia Wanru, Jia Xiaohong, Zhang Jingwen, Zhu Ying, Mao Minjing, Ying Haifeng, Zhan Weiwei, Zhou Jianqiao
Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Scientific Research, Shanghai Aitrox Technology Corporation Limited, Shanghai, China.
Quant Imaging Med Surg. 2025 Sep 1;15(9):8125-8136. doi: 10.21037/qims-2024-2879. Epub 2025 Aug 19.
Preoperative evaluation of sentinel lymph nodes is very important in breast cancer patients. This study aimed to explore factors affecting the result of preoperative percutaneous contrast-enhanced ultrasound for sentinel lymph nodes (SLN-CEUS) using Sonovue.
A total of 176 patients with breast cancer who underwent preoperative SLN-CEUS to trace axillary sentinel lymph nodes were included. The positive result of SLN-CEUS was defined as both lymphatic vessels and SLN visible. The negative result was defined as the visible lymphatic vessels but the SLNs invisible, and neither lymphatic vessel nor SLNs invisible. Clinical features, histopathology, ultrasound features and doses of contrast agents were analyzed between the positive and negative groups.
The diagnostic sensitivity, specificity, and accuracy of SLN-CEUS were 81.5%, 90.7%, and 87.8% respectively. The false negative and false positive rates were 18.5% and 9.3%. Age, distance from the anterior edge of the mass to the body surface (DTS), tumor location, pathologies and lymph nodes metastasis were significantly correlated with the results of SLN-CEUS between the negative and positive groups (P=0.032, 0.035, 0.036, 0.047 and <0.001). Logistic regression showed that age, location, DTS, and lymph node metastasis were independent factors influencing negative SLN-CEUS.
In conclusion, independent factors affecting negative results of SLN-CEUS were lymph node metastasis, age, tumor location and DTS.
前哨淋巴结的术前评估在乳腺癌患者中非常重要。本研究旨在探讨使用声诺维进行术前经皮超声造影剂增强超声检查前哨淋巴结（SLN-CEUS）结果的影响因素。
共纳入176例接受术前SLN-CEUS以追踪腋窝前哨淋巴结的乳腺癌患者。SLN-CEUS的阳性结果定义为淋巴管和前哨淋巴结均可见。阴性结果定义为可见淋巴管但前哨淋巴结不可见，以及淋巴管和前哨淋巴结均不可见。分析了阳性组和阴性组之间的临床特征、组织病理学、超声特征和造影剂剂量。
SLN-CEUS的诊断敏感性、特异性和准确性分别为81.5%、90.7%和87.8%。假阴性率和假阳性率分别为18.5%和9.3%。阴性组和阳性组之间的年龄、肿块前缘至体表的距离（DTS）、肿瘤位置、病理类型和淋巴结转移与SLN-CEUS的结果显著相关（P = 0.032、0.035、0.036、0.047和<0.001）。Logistic回归显示，年龄、位置、DTS和淋巴结转移是影响SLN-CEUS阴性结果的独立因素。
总之，影响SLN-CEUS阴性结果的独立因素是淋巴结转移、年龄、肿瘤位置和DTS。
