摘要
目的:探讨MRI在乳腺癌腋窝前哨淋巴结(SLN)转移中的诊断价值。方法:回顾性分析2015年1月-2017年6月在我院就诊的85例乳腺癌患者的临床资料及MRI影像学资料。采用秩和检验比较MRI检查和美兰示踪法检出SLB的数目、采用Spearman分析两种方法检出SLB的相关性,评估MRI诊断乳腺癌腋窝前哨淋巴结转移的敏感性、特异性和准确度。结果:85例患者,MRI检查定位145枚M-SLN,美兰示踪定位167枚D-SLN,两种方法检出的SLB的数目比较差异有统计学意义(P<0.05),但两种方法存在明显相关性(Rs=0.773,P<0.05)。MRI诊断M-SLN阳性92枚,阴性53枚,良恶性淋巴结的形态大小(长/短径)、淋巴门是否存在、周围脂肪间隙、DWI信号和ADC值、强化程度等方面的差异具有统计学意义(P<0.05)。MRI诊断乳腺癌腋窝前哨淋巴结转移的灵敏度为95.8%(91/95),特异度为98.0%(49/50),准确度为96.6%(140/145)。结论:MRI具有无辐射、软组织对比好、安全性高等优点,诊断乳腺癌腋窝前哨淋巴结转移的准确度较高,可成为临床专科医师术前常规检查方法。
Objective：To investigate the value of MRI in the diagnosis of axillary sentinel lymph node metastasis in breast cancer.Methods：The clinical and MRI imaging data of 85 patients with breast cancer in our hospital from January 2015 to June 2017 were analyzed retrospectively.The number of sentinal lymph nodes（SLNs）detected by MRI and by methylene blue staining and tracing were compared by paired samples rank-sum test and the correlation was analyzed by Spearman rank correlation test.The sensitivity,specificity and accuracy of MRI in the diagnosis of axillary SNL metastases in breast cancer was evaluated.Results：A total of 145 M-SLNs were detected by MRI,while 167 D-SLNs were detected by methylene blue staining and tracing.The number of SLB stained by methylene blue was obviously more than the SLB detected by MRI（P〈0.05）,but there was a strong correlation between the number of SLB detected by the two methods（Rs=0.773,P〈0.05）.A total of 92 positive M-SLN was diagnosed by MRI.Lymph node morphology,long-to-short long/short diameter ratio,existence of lymph gland hilum,ADC value,perilymphatic fat space,DWI signal and degree of enhancement etc showed difference with statistical significance（P〈0.05）.The sensitivity,specificity and accuracy of MRI in the diagnosis of axillary sentinel lymph node metastases in breast cancer were 95.8%（91/95）,98%（49/50）and 96.6%（140/145）,respectively.Conclusion：MRI has the advantages of no radiation,good soft tissue contrast and high safety.The accuracy of MRI in the diagnosis of axillary sentinel lymph node metastasis in breast cancer is high.It can be used as a routine examination method for clinical specialist before operation.
作者
苟军
胥化虎
杨桂松
何晓琴
GOU Jun;XU Hua-hu;YANG Gui-song(Department of Radiology,Mianyang Hospital of Traditional Chinese Medicine,Sichuan 621000,China)
出处
《放射学实践》
北大核心
2018年第6期574-578,共5页
Radiologic Practice
关键词
磁共振成像
乳腺肿瘤
前哨淋巴结
诊断
Magnetic resonance imaging
Breast neoplasms
Sentinel lymph node
Diagnosis
