摘要目的:探讨超声诊断乳腺癌腋窝淋巴结转移的价值。方法:抽取2019年10月至2023年10月延安大学咸阳医院收治的82例乳腺癌患者作为研究对象，均接受手术治疗，术前均行超声检查。以手术病理结果为标准，对超声诊断的结果进行回顾性分析。按照手术病理结果将82例乳腺癌患者分为两组，其中发生腋窝淋巴结转移为转移组，未发生转移则为未转移组。比较两组超声声像图特点、血流信号特征。结果:82例乳腺癌患者术后病理证实发生腋窝淋巴结转移40例，腋窝淋巴结未转移42例；术前超声检查检出腋窝淋巴结转移38例，未转移44例；诊断准确度为92.68%(76/82)，特异度为95.24%(40/42)，灵敏度为90.00%(36/40)。超声声像图显示，转移组皮质向心型增厚、淋巴结内钙化灶、淋巴结长短径比<2、淋巴结边界不清检出率高于未转移组( P<0.05)。超声血流信号特征结果显示，转移组血流分布情况中周边型高于未转移组，门型低于未转移组( P<0.05)；转移组血流信号分级中2级占比低于未转移组，3级占比高于未转移组( P<0.05)。 结论:腋窝淋巴结转移与未转移的乳腺癌患者在超声声像图特点、血流信号特征方面存在明显差异，超声在乳腺癌腋窝淋巴结转移诊断中有较高的诊断效能。

abstractsObjective:To investigate the value of ultrasonography in the diagnosis of axillary lymph node metastasis in breast cancer.Methods:Eighty-two breast cancer patients admitted to Xianyang Hospital of Yan’an University from October 2019 to October 2023 were selected as the research objects. All of them received surgical treatment and underwent preoperative ultrasound examination. The results of surgical pathology were taken as the standard to retrospectively analyze the results of ultrasound diagnosis. According to the results of surgical pathology, the 82 patients with breast cancer were divided into two groups, among which patient with axillary lymph node metastasis was set as the metastasis group, and patients without metastasis as the non-metastasis group. The ultrasonographic characteristics and blood flow signal characteristics of the two groups were compared.Results:Among the 82 patients with breast cancer, 40 cases were confirmed with axillary lymph node metastasis, and 42 cases were confirmed without axillary lymph node metastasis by postoperative pathology; 38 cases were confirmed with axillary lymph node metastasis, and 44 cases were confirmed without axillary lymph node metastasis by preoperative ultrasonography. The diagnostic accuracy of ultrasonography was 92.68% (76/82), the specificity was 95.24% (40/42), and the sensitivity was 90.00% (36/40). The ultrasonographic features showed the detection rates of centripetal cortical thickening, calcification in lymph nodes, lymph node length to short diameter ratio <2, and unclear lymph node boundary in the metastasis group were higher than those in the non-metastasis group ( P<0.05). The results of ultrasound blood flow signal characteristics showed that the peripheral blood flow distribution in the metastasis group was higher than that in the non-metastasis group, and the portal blood flow was lower than that in the non-metastasis group ( P<0.05). The proportion of grade 2 blood flow signals in the metastasis group was lower than that in the non-metastasis group, and the proportion of grade 3 was higher than that in the non-metastasis group ( P<0.05). Conclusions:There are significant differences in ultrasonographic characteristics and blood flow signal characteristics between breast cancer patients with and without axillary lymph node metastasis. Ultrasonography has a high diagnostic efficiency in the diagnosis of axillary lymph node metastasis in breast cancer.