The Contrast Agents Of Ultrasound In Sentinel Lymph Nodes Of Breast Masses

Objective To explore the perspective and effectiveness of contrast-enhanced ultrasound by subcutaneous injection SonoVue in sentinel lymphatic node (SLN) through two parts. Primary part was performed in ten swine after intradermal and subcutaneous injections in 40 places of the axillas and ilnguinal region with a sonographic contrast agent (Sonovue). To investigate the mechanism and the vale of its clinical application.The second part was 42 patients with breast masses by conventional techniques. The SLN were detected and observed by contrast enhanced ultrasound(CEUS), the same spot injecting MB, comariing the superiority,anticipating the vale of its clinical application. Methods Primary part :Performed in ten swine after subcutaneous injection in 40 places of the primary nipple side (both sides) and inguinal region (both sides),observing enhancement of SLN in axillas as well as neck thoracic region and inguinal region, recording the beginning enhance time of Lymphatic channel ,the number and location of SLN with a sonographic contrast agent (Sonovue) were detected by subcutaneous injected methylene blue. The second part was each injected subcutaneously with 1.25 ml SonoVue in 3,6,9,12 pnts directly superficial to the borderline breast tumor.The SLN were detected and observed by CEUS. recording the start time of enhancement of lymphatic channel and lymph nodes, the number of enhancement of the lymph nodes and the position, recording the time of regression. Methylene blue was subcutaneously injected, then the diagnosis obtained by means of surgical biopsy. Results Primary part twenty-nine SLN were detected in axillas including neck thoracic region of 10 swine. Thirty-six SLN were detected in inguinal region. According to the subcutaneous injected methylene blue method, the accurate rate of contrast-enhanced ultrasound of in detecting SLN was 87.8% (65/74), neck thoracic region was 82.9% (29/35),inguinal region was 92.3% (36/39). The second part SLN were successfully detected in 30 of 42 patients.Success rates were 71.4%.The total number of detected SLN was 40. 5 of 10 patients in optimum. Success rates were 50%. The total number was 5. 25 of 32 patients with breast cancer.Success rates were 78.1%. The total number was 35. SLN were successfully detected in 39 of 42 patients with Methylene blue ,the accurate rate was 92.9%. The total number was 64. 7 in optimum. The total number was11. 32 in breast cancer. The total number was 53. Conclusions (1) By subcutaneous injection of ultrasound contrast agent SonoVue, can well imaging of the lymphatic vessels and lymph node .(2) by subcutaneous injection of SonoVue in tumor edge,it can be accurately determined through a higher SLN rate on breast cancer patients and whether there is a metastases within. (3) The edge of subcutaneous tumors after injection of SonoVue, ultrasound and pathology to compare the accuracy of SLN detected no significant difference in contrast agent is expected in the SLN of breast cancer patients will have broad prospects for application..