Preoperative assessment value of enhanced CT for axillary lymph node in breast cancer / 中华内分泌外科杂志

ABSTRACT

Objective To study the assessment value of enhanced CT for axillary lymph node in breast cancer.Methods 71 patients meeting the inclusion criteria in our hospital were reviewed.They had level Ⅲ lymph nodes pathologically confirmed for almost 2 years.CT scan by a 64-detector row scanner were performed from the lower edge of breast to neck.CT images were analyzed from these aspectswith or without lymph node enlargement; the size and shape of the lymph nodes; lymph node with or without enhancement.Through the determination of CT net increase value,the metastasizing lymph node signs were explored.Diagnostic index of axillary lymph nodes imaged by breast sonography and enhanced CT were calculated separately.The size of level Ⅲ lymph node and CT net increase value were statistically analyzed.The correlation of metastasizing level Ⅲ lymph node and tumor location was analyzed.Results The accuracy,sensitivity,specificity,and positive predictive value of diagnosed axillary lymph node was 70.4％,85.7％,64.0％,and 50.0％ by three-dimensional ultrasound and 88.7％,90.6％,83.3％,and 94.1％ by enhanced CT.The accuracy,sensitivity,specificity,and positive predictive value of diagnosed level Ⅲ lymph node was 95.8％,90.5％,98.0％,and 95.0％ by enhanced CT.The maximal diameter of level Ⅲ lymph node was ＞ (8.7 ± 1.3) mm and the short diameter was ＞ (5.3 ±0.5) mm.CT net increase value was ＞ (50.0 ±9.0) HU.The shape of lymph nodes was mainly round or oval solid.Conclusions The diagnosis rate for level Ⅲ lymph node is obviously higher by enhanced CT than by three-dimensional ultrasound.There is no obvious correlation between level Ⅲ lymph node and tumor location.