摘要
目的在肿瘤周围皮下注射超声造影剂,观察是否能够探测淋巴管和前哨淋巴结,是否能够探测前哨淋巴结内的转移灶。方法用普通超声、彩色多普勒和反向灰阶二次谐波超声对6头猪,17个黑色素瘤进行了研究。在肿瘤周边皮下注射超声造影剂Sonazoid(总量1ml)。淋巴超声造影后,进行99mTC硫化物胶体皮下注射,然后皮下注射。由两位医生来判断超声造影时是否前哨淋巴结有转移。结果超声造影发现28个前哨淋巴结,而淋巴系闪烁造影检出27个热点(Hotspots),可能为前哨淋巴结(2例假阳性)。蓝色染料注射后的手术切除检出31个前哨淋巴结。超声探测前哨淋巴结无假阳性。淋巴系闪烁造影漏诊6个前哨淋巴结;这其中5个前哨淋巴结,皮下注射超声造影剂后都能清晰显示。皮下超声造影探测前哨淋巴结的准确性为90%(28/31),而淋巴系闪烁造影为81%(p=0.29)。皮下注射超声造影剂在20个发生转移的前哨淋巴结中,成功检出19个;在8个无转移的前哨淋巴结中,成功检出5个,准确性86%(k=0.62)。结论皮下注射超声造影剂后都能显示前哨淋巴结,并可显示前哨淋巴结内的转移灶。皮下超声造影比淋巴系闪烁造影更有效。
Purpose To evaluate the value of lymphatic uhrasonography （US） in detecting lymphatic channel and sentinel lymph nodes （SLNs） with or without metastasis. Methods We evaluated 6 swine with 17 melanomas with conventional gray-scale US, CDFI and gray-scale phase-inversion harmonic US. A contrast agent （Sonazoid） was administered in four sites around each melanoma （totally lml）. Lymphoscintigraphy was followed by the injection of a blue dye and then dissection. SLNs identified at lymphatic US were assessed by two doctors in consensus as normal or as having metastasis. The results were compared with histological findings. Results Lymphatic US depicted 28 SLNs, while lymphoscintigraphy depicted 27 ＂hot spots＂ suspected to be SLNs （including 2 false positive findings）. Dissection after blue dye injection determined 31 SLNs. There were no false positive for US findings of SLN detection. Five in six cases of SLNs which were not detected with lymphoscintigraphy were detected with lymphatic US. The accuracy of lymphatic US for SLN detection was 90% （28/31）, and 81% （25/ 31） for lymphoscintigraphy （p=0.29）. Lymphatic US correctly depicted metastases in 19 of 20 SLNs, and 5/8 normal SLNs were correctly characterized with an accuracy of 86% （k=0.62）. Conclusion Contrast-enhanced lymphatic US can detect SLNs and its metastases, and it is more valuable than lymphoscintigraphy in detecting SLNs.
出处
《上海医学影像》
2006年第1期58-60,63,共4页
Shanghai Medical Imaging
关键词
超声
造影剂
前哨淋巴结
Ultrasonography
Contrast agent
Sentinel lymph nodes
