The Value Of Ultrasound Elastography In The Differential Diagnosis Of Axillary Lymlph Nodes In Breast Cancer

Objective To explore value of ultrasonic elastography(UE) and routineultrasound in the differential diagnosis of axillary lymlph nodes in breastcancer.Improve the level of ultrasound in the differential diagnosis of axillarylymph node status.Materials and Methods The subjects were94lymph nodes from94patients with breast cancer ipsilateral axillary，These patients are all female，arehospitalized in gastrointestinal gland surgery underwent surgery of the FirstAffiliated Hospital of Guangxi Medical University from December2012toDecember2013.Using two-dimensional ultrasound (2D-US) and ultrasonicelastography (UE) examination these axillary lymph nodes， Observe thesonographic features, measuring the size of the lymph nodes, cortical thicknessand calculate the aspect ratio (L/S),hardness of the tissue elasticityscore.compared with Histopathology after surgery,Evaluation of ultrasound inthe diagnosis of breast cancer patients with ipsilateral axillary lymph nodestatus. Results1.2D-US ipsilateral axillary metastatic lymph nodes of breastcancer compared with non-metastatic lymph nodes: lymph node L/S <2.0;cortical thickness≥0.3cm; lymphatic door disappeared. There was significantdifference between the contrast (p<0.05).2. Most non-metastatic lymph nodeselasticity score is1,2points, metastatic lymph nodes was3,4points. UsingUE≥3into cutoff value to diagnose axillary lymph node metastasis, thesensitivity, specificity and accuracy rates were84.31%(43/51),81.40%(35/43),82.98%(78/94).The accuracy of2D-US, UE and combine the two to diagnosisALN metastasis of breast cancer were75.53%,82.98%,92.55%, There hashigher accuracy combine2D-US and UE to diagnosis ALN metastasis then useboth diagnosis alone, the difference was statistically significant (p<0.05). UEalone diagnostic accuracy rate of lymph node metastasis in conventionalultrasound and three combined, the difference statistically significant(p<0.05).Lymph nodes which UE score of2,3points, most UE images appear inthe blue area surrounding, corresponding lymph node cortex,80%(28/35) bluearea only distributed in the cortex,20%(7/35) in the blue area the cortex andmedulla, the difference of blue distribution of this part of the axillary lymphnode in metastatic and non-metastatic groups was not statistically significant(P>0.05).Conclusion Ultrasound elastography has high diagnostic value of ALNmetastasis of breast cancer, most non-metastatic lymph nodes elasticity score is1,2points, metastatic lymph nodes was3,4points.2D-US combined UE canimprove diagnostic accuracy of ALN metastasis of breast cancer, UE can beused as a new clinical value diagnostic method of ALN metastasis of breastcancer.