实用医学杂志 ›› 2021, Vol. 37 ›› Issue (14): 1861-1865.doi: 10.3969/j.issn.1006⁃5725.2021.14.018

• 医学检查与临床诊断 • 上一篇    下一篇

CT淋巴造影联合三维可视技术在乳腺癌淋巴回流路径研究中的应用 

黄雷1, 余晋刚2, 叶建平3 ,王柏烨4 ,罗云峰1,欧彩凤1 ,朱迪1 ,张普生1   

  1. 南方医科大学珠江医院1 乳腺外科,4 影像诊断科(广州 510282);2 华南理工大学自动化科学与工程学院 (广州 510641);3 深圳市一图智能科技有限公司(广东深圳 518040)

  • 出版日期:2021-07-25 发布日期:2021-07-25
  • 通讯作者: 张普生 E⁃mail:drpushengz@163.com
  • 基金资助:

    广东省科技计划项目(编号:2016A020215208);南方医科大学珠江医院医疗新技术项目(编号:202001024)

Value of 3D CT ⁃ LG in identification and classification of lymphatic drainage pathway of breast cancer

HUANG Lei*,YU Jin′gang,YE Jianping,WANG Baiye,LUO Yunfeng,OU Caifeng,ZHU Di,ZHANG Pusheng.   

  1. *Department of Breast SurgeryZhujiang HospitalSouthern Medical UniversityGuangzhou 510282China
  • Online:2021-07-25 Published:2021-07-25
  • Contact: ZHANG Pusheng E⁃mail:drpushengz@163.com

摘要:

目的 探讨CT淋巴造影联合三维可视技术(three⁃dimensional computed tomography⁃lymphogra⁃ phy,3D CT⁃LG)在乳腺癌淋巴回流路径可视化及分型中的应用价值。方法 选取100例乳腺癌患者,术前使3D CT⁃LG法观察患者乳房淋巴回流路径类型。术中使用示踪剂法(亚甲蓝联合吲哚菁绿)验证3D CT⁃LG 法对淋巴回流路径分型的准确性。结果 3D CT⁃LG法共93例(93%)可进行分型。Ⅰ型(1根淋巴管连接1 前哨淋巴结)63例(65.6%),Ⅱ型(1根淋巴管连接多个前哨淋巴结)12例(13.5%),Ⅲ型(多根淋巴管连接1 前哨淋巴结)4例(5.2%),Ⅳ型(多根淋巴管分别连接多个前哨淋巴结)14例(15.6%)。示踪剂法95例可分型 95%),Ⅰ型62例(65.3%),Ⅱ型12例(12.6%),Ⅲ型6例(6.3%),Ⅳ型15例(15.8%)。一致性分析Kappa值: 0.912,P<0.05。结论 CT淋巴造影联合三维可视技术能准确可视化乳腺癌的淋巴回流并对其分型。

关键词:

三维可视化,  , 三维重建,  , 淋巴回流路径,  , 乳腺癌

Abstract:

Objective To explore the application value of three ⁃dimensional computed tomography ⁃lym⁃ phography(3D CT ⁃ LG)in the identification and classification of lymphatic drainage pathway of breast cancer. Methods 3D CT ⁃LG was performed in 100 cases diagnosed as breast cancer to reconstruct and distinguish the type of breast lymphatic drainage pathway before operation. Intraoperative methylene blue combined with indocya⁃ nine green was used to verify the accuracy of 3D CT⁃LG. Results A total of 93 cases(93%)could be classified by 3D CT⁃LG:63 cases(65.6%)as type Ⅰ(single lymphatic connected with one sentinel lymph node);12 cases (13.5%)as type Ⅱ(single lymphatic connected with multiple sentinel lymph nodes);4 cases(5.2%)as type Ⅲ (multi⁃root lymphatic connected with a sentinel lymph node)and14 cases(15.6%)as type Ⅳ(multi⁃root lymphatic connected with multiple sentinel lymph nodes). Ninety⁃five cases could be classified by tracer method(95%):62 cases(65.3%)as typeⅠ;12 cases(12.6%)as type Ⅱ;6 cases(6.3%)as type Ⅲ and 15 cases(15.8%)as type Ⅳ. Kappa value in consistency analysis was 0.912(P < 0.05). Conclusion 3D CT⁃LG can accurately identify lymphatic drainage pathway of breast cancer and plays an important role in the classification.

Key words:

3D visualization, 3D reconstruction, lymphatic drainage pathway, breast cancer ,