The Application Of Contrast-enhanced Ultrasound And Ultrasound Guided Wire Localization In The Study Of Sentinel Lymph Node In Breast Cancer

Objective:To explore the value of contrast-enhanced ultrasound imaging for detecting sentinel lymph node in breast cancer and the application of ultrasound guided wire localization.Method:Collection in the tumor hospital of Shanxi Medical University,in the period from March 2016 to December 2016 72 patients with pathological diagnosis of women breast cancer.Step one,gray-scale sonography scan contralateral breast and ipsilateral axillary lymph nodes and then measure the size and ortical thickness of suspicious lymph nodes and then mark the lymph nodes.Step two,preoperative 1hour the areola margin subcutaneously and the cut edge of original mass around 1cm inject ultrasound contrast agents for imaging sentinel lymph nodes and record their characteristics of sentinel lymph nodes of contrast-enhanced ultrasound enhancement(there are three kinds of enhanced mode:typeⅠ,SLN was obviously homogeneous enhanced:typeⅡ,SLN was not homogeneous enhanced,with hypo-perfusion or non-perfusion area present;type Ш,weakly enhanced or not enhanced)and compare the suspicious lymph nodes of gray-scale sonography.Step there,the SLNs that detected by contrast-enhanced ultrasound was positioned by wire location.Step four,all patients who receive a 2ml subdermal injection of carbon nanoparticles suspension.Then operator found the black-dyed lymph nodes and dissected the black dye lymph nodes and wire-localization lymph nodes to send frozen pathological examination.Results:1.In accordance with the surgical pathology results,a total of 72 cases of breast cancer patients to remove 206 pieces of sentinel lymph node.The number of ultrasound guide positioning of sentinel lymph nodes was less than the carbon nanoparticles dyeing(83vs123).Contrast-enhanced ultrasound guide positioning sentinel lymph node metastatic positive rate was 50.6%(42/83),than the positive rate of nano carbon staining(32.5%,40/123).(The P values were 0.009)2.83 Ultrasound guided wire localization of sentinel lymph nodes,uneven cartex thickening of metastatic lymph nodes,see more at cortical thickness≥3.0mm(41/42)3.In the three types of enhancement features of metastatic sentinel lymph node.The non-metastatic sentinel lymph node was found typeⅠ(35/39),metastatic sentinel lymph node was found typeⅡ、typeШ(37/42).Conclusion:1.Contrast-enhanced ultasound for sentinel lymph node in breast cancer had higher sensitivity.2.Conventional ultrasonic and contrast-enhanced ultrasound examination was expected to become an important noninvasive diagnostic method of sentinel lymph node status in breast cancer.3.The important value of the cortical thickness of lymph nodes to judge preoperative whether lymphnode metastatic or not.