Abstract:

Objective

To investigate the value of contrast-enhanced ultrasonography(CEUS)in detection of metastatic axillary lymph nodes in patients with breast carcinoma.

Methods

The breasts and axillae of 141 patients with breast carcinoma were examined with Ultrasound scans,followed by ultrasonography and CEUS of axillary lymph nodes.The perfusion patterns were assessed by direct visualization method.QontraXt software was subsequently used to determine the wash-in and wash-out parameters of each node.The axillary lymph nodes were divided into metastatic and nonmetastatic groups according to the perfusion features and were compared with the histopathologic diagnosis.The correlation of CEUS patterns with histopathology was analyzed by chi-square test.One-way analysis of variance was used to assess differences in perfusion parameters among the nodes.

Results

Homogeneous enhancement patterns were more frequently associated with non-metastasis of nodes,while heterogeneous enhancement patterns or avascular patterns were mostly suggestive of metastasis of nodes,with statistical difference between the two groups.No statistically significant difference was found in the arrival time,time to peak intensity,and peak signal intensity between the two groups(P=0.129,0.094,and 0.140,respectively).The difference between the maximum signal intensity and minimum signal intensity(SI_max- SI_min)were more obvious in metastatic nodes than in nonmetastatic ones(P=0.000).And histopathologic diagnosis could be predicted with a sensitivity of 93.3%and a specificity of 80.8%by the standardized value of SI_max-SI_min above 28.

Conclusion

Contrast-enhanced ultrasonography play a role in clinically discriminating metastatic from nonmetastatic lymph nodes in patients with invasive breast cancer.

Key words: Ultrasonography, Angiography, Breast neoplasms, Lymph node metastasis