Real-time Ultrasound Imaging Of The Sentinel Lymph Nodes Of The Stomach SonoVue In A Porcine Model

Objective：To investigate the mechanism of contrast-enhanced ultrasound in sentinellymph node(SLN) by injecting SonoVue into the serosa and mucosal layers of stomach, andevaluate the usefulness and safety of the CEUS-guided method with SonoVue in thelymphatic channels and SLN of the stomach (in porcine model), and finally predict theclinical value of SonoVue by observing its performance characteristics in the places surroundlymphatic system and celiac lymphatic system.Materials and methods:：SonoVue was injected into to10healthy porcine models at theserosa and mucosal layers of the stomach at approximately8cm from above the pylorus andproximately2cm away from the greater curvature of the stomach. And the enhancement ofSLN in stomach was observed in a real time and dynamic way, also the time, number andplace of enhanced lymphatic channel were recorded. Then the results were compared withblue dye-guided method in the same place.Results: First:(1)Sixty-eight SLN were detected in10swine, including twenty-six inserosa layer and forty-two in mucosal layer.(2)Compare with the blue dye-guidedmethod,the detection rate of SonoVue for SLN is95.8%(68/71); With the standard ofpathologic result, the accurate rate of CEUS is100%(68/68),and the accurate rate of bluedye-guided method is94.4%(67/71).(3)Real-time imaging mode of the CEUS, theenhance start time, reach the peak time and the duration time of SLN in serosa layer is longerthan mucosal layer, the three parameters between two groups are significantdifferent(P<0.05). Two:(1) Forty-five SLN were detected when with the blue method and forty-two SLNwere detected in CEUS;(2) when injected0.1ml SonoVue,there no SLN observed in thirtyminutes; when injected0.3ml,the start, reach the peak and the duration time of SLN inmucosal layer is longer than0.5ml(P<0.05).Conclusions: Ultrasound contrast agents SonoVue has a high security and better imagingeffect on detecting SLN in porcine model by injecting it into the serosa and mucosal layers ofswine. It can be predicted that SonoVue will play an important role in clinical application onstomach cancer of SLN.