| 赵 森,杜 森.间质磁共振淋巴管造影与扩散加权成像联合检测84例乳腺癌患者前哨淋巴结转移[J].肿瘤学杂志,2020,26(11):962-965. |
| 间质磁共振淋巴管造影与扩散加权成像联合检测84例乳腺癌患者前哨淋巴结转移 |
| Value of Interstitial MR Lymphangiography Combined with DWI Sequence in Detecting Sentinel Lymph Node Metastasis in Breast Cancer Patients |
| 投稿时间：2019-12-27 |
| DOI：10.11735/j.issn.1671-170X.2020.11.B007 |
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| 中文关键词: 乳腺癌 间质磁共振淋巴管造影 扩散加权成像序列扫描 前哨淋巴结转移 |
| 英文关键词:breast cancer interstitial magnetic responance lymphangiography diffusion-weighted imaging sequence scan sentinel lymph node metastasis |
| 基金项目:河南省医学科技攻关计划项目（2018020311） |
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| 中文摘要: |
| 摘 要：［目的］ 分析间质磁共振（magnetic resonance，MR）淋巴管造影与扩散加权成像(diffusion?鄄weighted imaging，DWI)序列结合诊断乳腺癌前哨淋巴结转移的价值。［方法］ 2016年11月至2018年12月纳入河南大学第一附属医院84例患者进行MR淋巴管造影、DWI序列扫描和病理活检。记录MRI诊断前哨淋巴结转移情况，对比转移组与非转移组前哨淋巴结MRI特征（形态、长径、短径、淋巴门、周围脂肪、ADC值、强化程度）；以ADC值为诊断前哨淋巴结性质的方法绘制ROC曲线以分析其诊断效能；分析间质MR淋巴管造影与DWI序列结合诊断乳腺癌前哨淋巴结转移的效能。［结果］ 84例患者中行MR淋巴管造影与DWI序列，联合检出46个转移淋巴结，26个非转移前哨淋巴结。与非转移前哨淋巴结相比，转移淋巴结主要表现为形态不规则、长径和短径更长，短径≥1cm者分布、无淋巴门者、周围脂肪间隙模糊者更多，ADC值更低，DWI普遍高信号，普遍明显强化。MR联合DWI检出72枚前哨淋巴结，每例患者平均检出（1.21±0.39）枚；活检检出75枚，每例患者平均检出（1.25±0.34）枚。MR联合DWI诊断腋窝前哨淋巴结转移的特异性为95.65%，敏感度为91.84%，阳性预测值为97.83%。［结论］ MR间质淋巴造影联合DWI序列能有效诊断乳腺癌前哨淋巴结转移，值得进一步推广。 |
| 英文摘要: |
| Abstract：［Objective］ To analyze the value of interstitial magnetic resonance(MR) lymphangiography combined with diffusion-weighted imaging(DWI) sequence in the diagnosis of sentinel lymph node metastasis in breast cancer patients. ［Methods］ From November 2016 to December 2018，84 patients admitted in the First Affiliated Hospital of Henan University underwent MR lymphangiography，DWI sequence scanning and pathological biopsy. The MRI features(morphology，long diameter，short diameter，lymphadenopathy，peripheral fat，ADC value and enhancement degree) of sentinel lymph nodes were compared between the metastatic group and the non-metastatic group. The ADC value was used to diagnose the nature of sentinel lymph nodes. ROC curve was used to analyze the diagnostic efficiency(specificity，sensitivity，positive predictive value). ［Results］ In 84 patients，46 metastatic lymph nodes and 26 non-metastatic sentinel lymph nodes were detected by MR lymphangiography combined with DWI sequence. Compared with non-metastatic sentinel lymph nodes，the metastatic lymph nodes had irregular shape，longer long diameter and short diameter; and more proportion of lymph nodes with short diameter≥1cm，no hilus，blurred peripheral fat space，lower ADC value，high DWI signal and significant enhancement. When cutoff value of ADC was 0.910，the specificity，sensitivity and positive predictive value were 90.15%，87.01% and 92.17%，respectively. Seventy two sentinel lymph nodes were detected by MR combined with DWI，with an average of 1.21±0.39 in each patient; while 75 sentinel lymph nodes were detected by biopsy，with an average of 1.25±0.34 in each patient(P>0.05). With pathological finding as gold standard，the specificity，sensitivity and positive predictive value of MR combined with DWI in detection of axillary sentinel lymph node metastasis were 95.65%，91.84% and 97.83% respectively. ［Conclusion］ MR interstitial lymphography combined with DWI sequence can effectively diagnose sentinel lymph node metastasis of breast cancer，which is worthy of promotion. |
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