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目的评价经皮超声造影对兔乳腺引流淋巴结的示踪效果,探讨超声造影指导乳腺癌前哨淋巴结活检术的可行性。方法 20只兔(40侧乳腺)根据超声造影剂剂量不同分为4组(0.25、0.50、0.75、1.00 ml),乳头周围皮下注射造影剂后观察淋巴显像,然后美蓝示踪,将检出淋巴结切除并行组织病理学检查。结果经皮超声造影可以清晰地动态观察兔淋巴引流并存在显影时间窗。电镜下可于显影淋巴结内观察到造影剂微气泡。超声造影平均每侧腋窝检出1.09枚淋巴结,美蓝平均每侧腋窝检出1.16枚淋巴结,超声造影与美蓝的淋巴结检出率没有统计学差异(87.5%vs 80%,P>0.05)。结论实时超声造影可识别前哨淋巴结,经皮超声造影联合美蓝淋巴示踪可用于指导乳腺前哨淋巴结活检。
Objective To evaluate the tracing effect of percutaneous contrast-enhanced ultrasound (CEUS) on the draining lymph nodes in rabbits and to explore the feasibility of using ultrasound contrast to guide sentinel lymph node biopsy in breast cancer. Methods Twenty rabbits (40 breasts) were divided into 4 groups (0.25, 0.50, 0.75, 1.00 ml) according to the dose of ultrasound contrast agent. Lymphoscintigraphy was observed after subcutaneous injection of contrast agent around the nipple. Lymph node excision parallel histopathological examination. Results Percutaneous contrast echocardiography can clearly observe the lymphatic drainage in rabbits and the time window of development. Electron microscopy can be observed in the imaging lymph node contrast agent microbubbles. On the average, there were 1.09 lymph nodes on each side of the axillae detected by contrast-enhanced ultrasound and 1.16 lymph nodes on the axillary side of the methylene blue. There was no significant difference between the two groups (87.5% vs 80%, P> 0.05). Conclusion Real-time contrast-enhanced ultrasound can identify sentinel lymph nodes. Percutaneous contrast-enhanced ultrasound and methylene blue lymph node tracer can be used to guide the sentinel lymph node biopsy.