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目的探讨经皮下注射超声造影剂对乳腺癌前哨淋巴结(SLN)的诊断效果。方法选取2012年1月至2015年1月间上海市奉贤区中心医院收治的98例乳腺癌患者,所有患者先经皮下注射声诺维进行检查(观察组),后经腺体注射声诺维进行检查(对照组),对前后两次检查准确率、临床诊断效果及肿块结构病变情况进行定期随访、检测数据分析、影像学图像分析及记录详细临床信息。结果观察组SLN的诊断效果(灵敏度100.0%、特异度98.0%、准确度96.9%和阳性检出率87.8%)更优于对照组(86.7%、62.2%、77.6%和66.3%),两者差异均有统计学意义(均P<0.05)。观察组SLN检测的增强效果[增强时间(35.83±11.58)s、达峰时间(136.66±39.04)s和退减时间(1783.20士90.11)s]更优于对照组[(63.14±14.62)s、(242.57±43.82)s和(1964.62±96.28)s],差异均有统计学意义(均P<0.05)。经皮下注射造影剂检查对SLN病变的性质判定总准确率为87.8%,明显优于经腺体注射造影剂检查的66.3%,差异有统计学意义(P<0.05)。结论对乳腺癌患者进行诊断和治疗时,采取经皮下注射超声造影剂声诺维的方式有助于SLN诊断和性质判定,具有快速简便、合理有效、分辨率高及特异性好的临床效果,具有较高的临床推广价值。
Objective To investigate the diagnostic value of subcutaneous injection of ultrasound contrast agent on sentinel lymph node (SLN) in breast cancer. Methods A total of 98 patients with breast cancer who were admitted to Fengxian Central Hospital from January 2012 to January 2015 were enrolled in this study. All patients were examined by subcutaneous injection of SonoVue (observation group) (Control group). The patients were followed up regularly for the accuracy of the two tests, the clinical diagnosis and the lesions of the lumps. The data of the test, the image analysis and the detailed clinical information were recorded. Results The diagnostic results (sensitivity 100.0%, specificity 98.0%, accuracy 96.9% and positive detection rate 87.7%) of observation group were superior to those of control group (86.7%, 62.2%, 77.6% and 66.3% The differences were statistically significant (all P <0.05). Compared with the control group [(63.14 ± 14.62) s], the enhancement effect of SLN in the observation group (35.83 ± 11.58 s, peak time (136.66 ± 39.04 s) and retreating time (1783.20 ± 90.11 s) (242.57 ± 43.82) s and (1964.62 ± 96.28) s, respectively, with significant difference (all P <0.05). Subcutaneous injection of contrast medium to determine the nature of SLN lesions determine the total accuracy of 87.8%, significantly better than the gland injection of contrast agent examination of 66.3%, the difference was statistically significant (P <0.05). Conclusion In the diagnosis and treatment of patients with breast cancer, the subcutaneous injection of SonoVue ultrasound contrast medium is helpful for the diagnosis and property determination of SLN. The method has the advantages of rapid, simple, reasonable, effective, high resolution and good specificity. Has a high clinical value of promotion.