Experimental study in detecting sentinel lymph nodes by percutaneous transhepatic lymphosonography in VX2 hepatic cancer rabbit / 中华超声影像学杂志

ABSTRACT

Objective To investigate the feasibility and promising applications of percutaneous transhepatic lymphosonography in detecting sentinel lymph nodes(SLNs).Methods Twenty five rabbits with VX2 tumor were included in this study.0.05 ml SonoVue was injected into the liver parenchyma at 12,3,6,9 points around the VX2 tumor.The situation of contrast-enhanced lymph-vessel emited from injected point and lymph nodes in hepatic portal or around tumor was observed,and then the position of the lymph nodes were detected with the help of the mark on the surface of the portal vein,caput pancreatis,collum vesicae biliaris.Methylene blue (MB) was injected in the same way as above.The injected points were massaged for five minutes,and then executed the experimental rabbits.The lymph nodes enhanced and all the lymph node dyed or not were taked out for recorded and pathologic examination.Results 34 SLNs were conformed by operation and pathological diagnosis in all the rabbits.All SLNs were confirmed pathologically,28 lymph nodes which were checked out by percutaneous transhepatic lymphosonography were all SLNs.In all the 31 lymph nodes which were checked out by MB,25 lymph nodes were SLNs and the rest were the second degree lymph nodes.The detection rate of percutaneous transhepatic lymphosonography (82.4％) and the MB (91.2％) showed no significant difference(P =0.169).There were 6 SLNs enhanced uniformitily in which 2 SLNs encroach by cancer cell and 22 enhanced asymmetrically in which 21 SLNs encroach by cancer cell.The sensitivity,specificity and accuracy of percutaneous transhepatic lymphosonography to detcect the SLNs benign or malignancy was 95.5％ (21/28),66.7％(4/6) and 89.3 ％ (25/28).Conclusions Percutaneous transhepatic lymphosonography is a reliable and noninvasive method to detect and estimate the SLNs of hepatic cancer.