超声、增强CT与增强MRI在乳腺癌腋窝淋巴结转移中的诊断价值比较
方案。
[关键词] 乳腺癌;增强CT;超声;增强MRI;腋窝淋巴结转移
[中图分类号] R737.9 [文献标识码] B [文章编号] 1673-9701（2019）07-0094-05
[Abstract] Objective To evaluate and compare the diagnostic and clinical value of ultrasound， enhanced CT， enhanced MRI and their combination in preoperative diagnosis of axillary lymph node metastasis of breast cancer. Methods 105 female patients with breast cancer diagnosed in our hospital from January 2017 to June 2018 were selected. All patients were given breast ultrasound， axillary enhanced CT， and breast enhanced MRI before operation. The results of lymph node pathological examination were used as the gold standard. The imaging results and postoperative pathology were compared. Results Among the 105 patients with breast cancer， a total of 59 patients were confirmed with axillary lymph node metastasis by postoperative pathology. The sensitivity of ultrasound， enhanced CT， enhanced MRI and combined diagnosis was 71.2%， 84.7%， 57.6%， and 88.1%， respectively; the specificity was 65.2%， 76.1%， 78.3%， and 56.5%， respectively; the positive predictive value was 72.4%， 82.0%， 77.3%， and 72.2%， respectively; the negative predictive value was 63.8%， 79.5%， 59.0%， and 78.8%， respectively; the accuracy was 68.6%， 81.0%， 66.7%， and 74.3%， respectively. The sensitivity and accuracy of enhanced CT were higher than those of ultrasound and enhanced MRI （P=0.005， P=0.043）; the sensitivity of combined diagnosis（88.1%） was higher than those of ultrasound （71.2%） and enhanced MRI（57.6%）， respectively（P=0.022， P=0.000）; the specificity of combined diagnosis（56.5%） was lower than those of enhanced CT and enhanced MRI（P=0.047， P=0.026）. Conclusion Although the sensitivity and accuracy of enhanced CT are higher than those of ultrasound and enhanced MRI， preoperative evaluation of axillary lymph node status in breast cancer patients should use combined imaging techniques such as ultrasound， enhanced CT and enhanced MRI to determine the most suitable therapy for patients.