| Background and purpose Breast cancer is the most common malignancy of women,whether axillary lymph node metastasis is an important prognostic indicator, but alsoour important basis for the development of postoperative adjuvant treatment regimen.Axillary lymph node dissection surgery is the only reliable means of determiningaxillary lymph node metastasis, but after pathologically confirmed axillary lymph nodedissection, a considerable part of the victim did not happen. So how accuratepreoperative axillary lymph node predicts diagnosis to identify patients with a high riskof metastasis, develop individualized treatment programs, has become a new hotspot.Ever rely on palpation, ultrasound and X-ray mammography for evaluation of thepresence of lymph node metastasis was significantly less, with the development ofimaging equipment and technologies, Value of magnetic resonance imaging diagnosis ofbreast cancer is increasingly being recognized by the medical profession at home andabroad, but because of MR imaging time is long, expensive and not yet widely used.MSCT with its high temporal resolution and three-dimensional reconstruction techniquefor breast cancer before surgery with axillary lymph node status assessment has uniqueadvantages, Which MPR Restructuring image can be more intuitive clearly showedlesions and adjacent relationship with the surrounding tissue. Preoperative surgicalgrade and develop breast cancer, prognosis and guide treatment are important. Objective Discussion MSCT and MPR to determine the accuracy of axillary lymphnode metastasis of breast cancer to explore their clinical staging, surgical options, suchas clinical value of chemotherapy.Materials and Methods In this study, with64rows of128slice spiral CT in45patients with localized puncture and biopsy confirmed and pseudo operation in patientswith breast cancer treated by conventional axial scanning, observe the treatmenttechnology and the volume data for MPR image. The operation excision tumor andaxillary lymph node dissection pathology results as the gold standard, and record the CTmanifestation of axillary lymph node of breast cancer, including axillary lymph node thelongest, shortest axis, longest–shortest axis ratio,lymph hilum exists or not, the edge. Alldata using SPSS17.0statistical software for analysis, calculation of correlation wasobserved between the index and axillary lymph node metastasis, and kappa test toobserve the consistency index and pathological evaluation. And calculate the diagnosticsensitivity, specificity and accuracy. In the MSCT image evaluation of axillary lymphnode, with a single lymph node as a unit, the first assessment of a single lymph nodescore, then do ROC curve, the optimal diagnostic critical value. Will be greater than orequal to the score for the metastatic lymph nodes, this fraction following as nonmetastatic lymph nodes, and find the diagnostic sensitivity, specificity and accuracy.Result85axillary lymph nodes in breast cancer patients45cases were observed,including metastatic lymph node37, non metastatic lymph node48. there shows a poorfit degree that we only use the longest axis or the shortest axis to diagnose axillarylymph node metastasis, Kappa values were0.34and0.30. there shows a General degreethat we only use longest–shortest axis ratio,lymph hilum structure exist or not todiagnose axillary lymph node metastasis, Kappa values were0.54and0.71. The abovefour indexes diagnostic, The highest sensitivity is longest–shortest axis ratio, is91.9%, the highest specificity and accuracy is the lymph door exists or not,is91.7%and85.9%.When MSCT image comprehensive evaluation axillary lymph nodes, the area under theROC curve was0.903, the optimal diagnostic critical value is3. there shows a poor fitdegree that we use it to diagnose axillary lymph node metastasis, Kappa values was0.764. The diagnostic sensitivity, specificity and accuracy were91.9%,85.4%and88.2%.Conclusion MSCT and MPR have an important value for axillary lymph node inbreast cancer patients with preoperative assessment. MSCT image comprehensiveevaluation than alone with the longest axis, the shortest axis, longest–shortest axis ratioand the lymph hilum exists or not to evaluate the axillary lymph node has an advantagemore, high diagnostic accuracy. |
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