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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2021, Vol. 18 ›› Issue (02) : 159 -163. doi: 10.3877/cma.j.issn.1672-6448.2021.02.007

所属专题： 乳腺超声； 文献；

浅表器官超声影像学

SonoVue及Sonazoid在早期乳腺癌患者前哨淋巴结定位中的初步研究
孙彦1, 雷玉涛2,†(), 郝云霞1, 王淑敏1, 谭石1, 崔立刚1   
  1. 1. 100191　北京大学第三医院超声科
    2. 100191　北京大学第三医院普外科
  • 收稿日期:2020-05-19 出版日期:2021-02-01
  • 通信作者: 雷玉涛
  • 基金资助:
    北京大学第三医院临床重点项目孵育项目A类(Y78480-02)

Comparison of SonoVue and Sonazoid in localization of sentinel lymph nodes in early breast cancer patients

Yan Sun1, Yutao Lei2,†(), Yunxia Hao1, Shumin Wang1, Shi Tan1, Ligang Cui1   

  1. 1. Department of Ultrasound, the Third Hospital of Peking University, Beijing 100191, China
    2. Department of General Surgery, the Third Hospital of Peking University, Beijing 100191, China
  • Received:2020-05-19 Published:2021-02-01
  • Corresponding author: Yutao Lei
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孙彦, 雷玉涛, 郝云霞, 王淑敏, 谭石, 崔立刚. SonoVue及Sonazoid在早期乳腺癌患者前哨淋巴结定位中的初步研究[J]. 中华医学超声杂志（电子版）, 2021, 18(02): 159-163.

Yan Sun, Yutao Lei, Yunxia Hao, Shumin Wang, Shi Tan, Ligang Cui. Comparison of SonoVue and Sonazoid in localization of sentinel lymph nodes in early breast cancer patients[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(02): 159-163.

目的

探讨SonoVue及Sonazoid在早期乳腺癌患者前哨淋巴结（SLN）定位中的应用。

方法

纳入2018年1月1日至2020年1月30日于北京大学第三医院就诊的临床诊断为乳腺癌T1~2期的患者204例。所有患者均行腋窝淋巴结清扫术或SLN活检术取得病理结果，术前均行超声造影检查。依据超声造影剂选用类型的不同，将204例患者分为SonoVue组135例（男性1例），Sonazoid组69例。观察2组SLN显影的数量、持续时间等，并分别与美蓝染色方法进行对比分析。

结果

SonoVue组135例患者，超声造影检出SLN共210个，美蓝染色检出297个，差异有统计学意义（t=6.964，P＜0.001）；Sonazoid组69例患者，超声造影检出SLN共102个，美蓝染色检出139个，差异有统计学意义（t=3.763，P＜0.001）。SonoVue组135例患者中1例造影定位未成功，美蓝染色定位显影失败4例；Sonazoid组68例患者全部成功定位，美蓝染色定位显影失败3例，2组显影成功率分别与美蓝染色比较，差异均无统计学意义（P=0.370、0.244）。SonoVue组与Sonazoid组之间的显影成功率比较（99.3% vs 100.0%），差异无统计学意义（P＞0.05）。造影剂注射后60、120 min时，SonoVue组SLN内均未见淋巴结显影，而Sonazoid组切除的蓝染淋巴结在生理盐水中均持续显影。

结论

Sonazoid在定位早期乳腺癌患者SLN中的应用价值不低于SonoVue，其在SLN中持续显影的特性有望用于术中检验切除SLN的准确性及完整性。

关键词: 超声检查, 造影剂, 前哨淋巴结, 乳腺癌
Objective

To compare the application of SonoVue and Sonazoid in the localization of sentinel lymph nodes (SLN) in early breast cancer patients.

Methods

A total of 204 patients with T1-2 breast cancer diagnosed at Peking University Third Hospital from January 1, 2018 to January 30, 2020 were included. All patients underwent axillary lymph node dissection or sentinel lymph node biopsy to obtain the pathological results, and all patients underwent contrast-enhanced ultrasound examination before operation. According to the type of contrast agent used, the patients were divided into either a SonoVue group (135 cases, including 1 male case) or a Sonazoid group (69 cases). The number and time of enhancement of SLN in the two groups were observed, and the two contrast agents were then compared with methylene blue staining.

Results

Among the 135 patients in the SonoVue group, 210 SLNs were detected by CEUS and 297 by methylene blue staining, and the difference was statistically significant (t=6.964, P=0.000); among 69 patients in the Sonazoid group, 102 SLNs were detected by CEUS and 139 by methylene blue staining, and the difference was also statistically significant (t=3.763, P=0.000). Among the 135 patients in the SonoVue group, 1 failed in angiography localization, and 4 failed in methylene blue staining localization; all the 68 patients in the Sonazoid group all succeeded in localization, but 3 cases failed in methylene blue staining localization, with no significant difference (P=0.370, 0.244).The success rate of enhancement between in the SonoVue and Sonazoid groups was 99.3% vs 100%, and the difference was not statistically significant (P＞0.05).There was no SLN enhancement in the SonoVue group at 60 and 120 min after injection of the contrast medium. The blue stained lymph nodes in the Sonazoid group had continued enhancement in saline.

Conclusion

The diagnostic value of Sonazoid in sentinel lymph nodes in early breast cancer patients is not lower than that of SonoVue,and its ability of continuous enhancement of SLN is expected to be used for intraoperative confirmation of the accuracy and completeness of SLN removal.

Key words: Ultrasonography, Contrast medium, Sentinel lymph node, Breast carcionma
图1 前哨淋巴结的灰阶超声与Sonazoid超声造影图像。左图灰阶超声淋巴结显示不满意；右图为Sonazoid超声造影可清晰显示前哨淋巴结及引流淋巴管走行
图2 术前Sonazoid超声造影定位的前哨淋巴结切除术后大体标本肉眼观及置于生理盐水中的超声造影图像。图a示术前超声造影显影的前哨淋巴结与术中蓝染淋巴结相符（箭头所示为引流蓝染的小段淋巴管及淋巴结），周围为淋巴结周围少量脂肪组织；图b为已切除的前哨淋巴结置于生理盐水中，Sonazoid超声造影可清晰显示淋巴结及引流的小段淋巴管（箭头所示），周围脂肪组织未见造影剂显影
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