| Purpose: The aim of this study is to combine colour Doppler flow,grey-scale ultrasound(US)and contrast-enhanced ultrasound(CEUS)for the prediction of the presence of axillary lymph node metastasis in patients with breast cancer.Can CEUS improve the accuracy of conventional USMaterials and methods: The colour Doppler flow,grey-scale US and CEUS features of axillary nodes of 234 patients were retrospectively analysed.Different US patterns and parameters were evaluated.The correlation of US patterns and parameters with prognostic factors was analysed with the t-test,chi-squared tests,receiver operator characteristic curve and logistic regression analysis.Multivariate logistic regression analysis showed that cortical thickness greater than or equal to 3 mm,LN type of grey-scale US,vascular pattern and enhancement pattern for the identification of benign and malignant lymph nodes were statistically significant.Results: Cortical thickness was the most accurate criterion for malignant axillary lymph nodes(P<0.001,area under the curve [AUC] = 0.808),followed by LN types of grey-scale US(P<0.001,AUC=0.786),non-perihilar vessel(P<0.001,AUC=0.779).The absence of hilum,cortical thickness/ L,Non-perhilar vessel and resistive index(RI)≥0.7 showed highest specificity for malignant lymph node(97.8%,91.6%,94.9%,97.8%),but low sensitivity(27.5%,44.8%,53.3%,23%).Conventional US(grey-scale US and colour flow US)had sensitivity,specificity and AUC of 66.4%,93.7% and 0.807,respectively,while CEUS had 61.0%,92.5% and 0.775,respectively.Sensitivity of 96.2%,specificity of 59.2% and AUC of 0.777 were obtained when the methods were combined.No statistically significant difference was found between the two methods of appeal(P=0.146).Conclusions: Conventional US has a certain significance in the diagnosis of axillary lymph nodes in patients with breast cancer.As an auxiliary method,CEUS cannot improve the accuracy of conventional US. |
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