超声造影在结直肠癌术中前哨淋巴结显像中的应用研究

摘要

目的 探讨超声造影法在结直肠癌术中检测前哨淋巴结(SLN)的可行性及临床应用价值.方法 21例结直肠癌根治术患者,术中于肿块四周注射1％亚甲蓝,寻找被蓝染的SLN;于相同注射部位注射超声造影剂SonoVue,动态观察并标记显像SLN.对比超声造影法和亚甲蓝法对SLN的检出率和准确率.结果 注射SonoVue后能够获得清晰的传入淋巴管和SLN图像.超声造影法对腹膜反折以下的直肠癌患者SLN的检出率为92.31％,准确率为88.89％;亚甲蓝法对其检出率为84.62％,准确率为93.10％,两种方法比较差异无统计学意义(P＞0.05).结论 经黏膜下注射SonoVue可成功地定位腹膜反折以下直肠癌患者的SLN,预计在临床腹膜反折以下直肠癌患者SLN检查中具有潜在的应用价值.%Objective To study the feasibility of contrast-enhanced ultrasonography (CEUS) in detecting sentinel lymph node(SLN) in patients with colorectal cancer during operation and their clinical significance.Methods Twenty-one patients who underwent radical resection of a primary colorectal cancer were enrolled.During operation,1 ％ methylene blue was injected around the tumor,SLN mapping was performed.Then the SonoVue was injected at the same sites,CEUS was performed to observe changes of SLN in real time,and marked them.The SLN detection rate and accuracy of CEUS were compared to those of conventional dye guided method.Results The rectal cancer of below peritoneal reflex,the detection rate of CEUS for SLN was 92.31 ％,and the accuracy was 88.89％.The detection rate of dye guided method for SLN was 84.62％,and the accuracy was 93.10％,there was no statistically significant difference between CEUS and dye guided method (P ＞0.05).Conclusions When injected SonoVue in submucosal layer,the good mapping of SLN of patients with rectal cancer of below peritoneal reflex can be obtained,it will play an important role in clinical application to map SLN of patients with rectal cancer of below peritoneal reflex.