|
|
超声成像技术在乳腺癌术前应用及术后随访中的研究进展
|
Abstract:
本文详细阐述了超声成像技术在乳腺癌术前及术后随访中的应用进展。介绍了超声成像包含的多种技术及其特点，术前其可辅助治疗决策、评估新辅助化疗、引导穿刺活检、染色剂标记、神经阻滞、旋切以及射频消融等操作；术后能在预测肿瘤复发、鉴别瘢痕与复发、淋巴结及远处转移评估等方面发挥作用。同时分析了该技术应用的优势与面临的挑战，并对其智能化诊断、多技术融合以及个体化医疗等未来发展方向进行了展望，旨在为乳腺癌的诊疗提供更全面有效的参考。
This article details the advances in the use of ultrasound imaging in the preoperative and postoperative follow-up of breast cancer. It introduces the various technologies and their characteristics of ultrasound imaging, which can assist in treatment decision-making, evaluation of neoadjuvant chemotherapy, guidance of puncture biopsy, dye labeling, nerve block, rotational excision, and radiofrequency ablation in the preoperative period, and play a role in predicting tumor recurrence, identifying scarring and recurrence, and evaluating lymph node and distant metastasis in the postoperative period. At the same time, the advantages and challenges of this technology are analyzed, and the future development direction of intelligent diagnosis, multi-technology integration and individualized medical treatment is envisioned, aiming to provide a more comprehensive and effective reference for the diagnosis and treatment of breast cancer.
| [1] | Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R.L., Soerjomataram, I., et al. (2024) Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 74, 229-263. https://doi.org/10.3322/caac.21834 |
| [2] | Xia, C., Dong, X., Li, H., Cao, M., Sun, D., He, S., et al. (2022) Cancer Statistics in China and United States, 2022: Profiles, Trends, and Determinants. Chinese Medical Journal, 135, 584-590. https://doi.org/10.1097/cm9.0000000000002108 |
| [3] | 李延会, 马雅秀, 范娜, 等. 彩色多普勒超声联合CT在乳腺癌腋下转移性淋巴结鉴别诊断中的应用[J]. 中国CT和MRI杂志, 2021,19(8): 95-97. |
| [4] | 徐会敏, 彭晓珊, 姜凯辉. 多模态超声技术在乳腺良恶性疾病中的应用[J]. 中外医学研究, 2024, 22(9): 157-161. |
| [5] | He, H., Wu, X., Jiang, M., Xu, Z., Zhang, X., Pan, J., et al. (2023) Diagnostic Accuracy of Contrast-Enhanced Ultrasound Synchronized with Shear Wave Elastography in the Differential Diagnosis of Benign and Malignant Breast Lesions: A Diagnostic Test. Gland Surgery, 12, 54-66. https://doi.org/10.21037/gs-22-684 |
| [6] | Wu, H., Wang, C., An, Q., Qu, X., Wu, X. and Yan, Y. (2022) Comparing the Accuracy of Shear Wave Elastography and Strain Elastography in the Diagnosis of Breast Tumors: A Systematic Review and Meta-Analysis. Medicine, 101, e31526. https://doi.org/10.1097/md.0000000000031526 |
| [7] | 杨超. 多模态超声对鉴别诊断乳腺结节良恶性的应用价值[D]: [硕士学位论文]. 佳木斯: 佳木斯大学, 2022. |
| [8] | 喻芬芬. 多模态超声在乳腺肿物良恶性鉴别中应用价值[D]: [硕士学位论文]. 西宁: 青海大学, 2023. |
| [9] | 成静, 李文肖, 吴芳, 等. 多模态超声预测乳腺癌腋窝淋巴结转移的价值[J]. 放射学实践, 2023, 38(11): 1447-1451. |
| [10] | 陈思思. 多模态超声成像评估乳腺癌腋窝前哨淋巴结转移的临床价值[D]: [硕士学位论文]. 南充: 川北医学院, 2021. |
| [11] | 岳民璐, 姜桂艳. 多模态超声动态评估乳腺癌新辅助化疗疗效[J]. 中国医学影像技术, 2024, 40(7): 1020-1024. |
| [12] | 张玉丽. 多模态超声对乳腺癌新辅助化疗疗效的评估[D]: [硕士学位论文]. 石家庄: 河北医科大学, 2023. |
| [13] | 党梓桁. 超声造影评估乳腺癌新辅助化疗后肿瘤退缩模式研究[D]: [硕士学位论文]. 太原: 山西医科大学, 2023. |
| [14] | 冯岩, 程嘉, 孟景茜. 超声引导下穿刺活检对早期乳腺癌的诊断价值[J]. 癌症进展, 2024, 22(4): 372-374. |
| [15] | 陈华琴, 金俊超, 桓新冬, 等. 超声引导下空芯针穿刺活检对乳腺癌的诊断价值[J]. 临床医学工程, 2023, 30(6): 745-746. |
| [16] | 张再重, 林楠, 王烈, 等. 染色标记技术在精准乳腺外科中的应用[J]. 中华乳腺病杂志(电子版), 2019, 13(2): 107-110. |
| [17] | 张宏旭, 刘海旺, 王助新, 等. 超声引导下染色剂标记切缘保乳手术在早期乳腺癌患者中的应用效果评价[J]. 川北医学院学报, 2021, 36(11): 1436-1440. |
| [18] | 杨勇丽, 耿智隆, 吴俊东, 等. 区域神经阻滞在乳腺癌术后镇痛中的应用研究进展[J]. 中国现代医学杂志, 2021, 31(5): 39-44. |
| [19] | Diéguez, P., Casas, P., López, S. and Fajardo, M. (2016) Ultrasound Guided Nerve Block for Breast Surgery. Revista Española de Anestesiología y Reanimación (English Edition), 63, 159-167. https://doi.org/10.1016/j.redare.2015.11.002 |
| [20] | 赵赢, 邵安民, 冯树全, 等. 超声引导下胸壁神经阻滞与胸椎旁神经阻滞用于乳腺癌改良根治术的镇痛效果[J]. 临床麻醉学杂志, 2020, 36(1): 58-62. |
| [21] | 付娇娇. 超声引导下胸神经阻滞在乳腺癌根治术后镇痛中的应用效果[J]. 中国医疗器械信息, 2022, 28(11): 115-117. |
| [22] | 尹秋稳, 郭启才, 苗秀美, 等. 超声引导下胸神经阻滞在乳腺癌改良根治术中的应用效果及对术后各阶段疼痛评分的影响[J]. 临床和实验医学杂志, 2023, 22(13): 1441-1445. |
| [23] | 何玉贤, 张哲明, 傅志荣. 麦默通微创旋切术在直径≥1cm乳腺结节患者中的应用效果[J]. 湘南学院学报(医学版), 2023, 25(4): 30-32. |
| [24] | 汪茜, 许涛. 超声引导下麦默通乳腺微创旋切术治疗乳腺良性肿瘤疗效及对乳房外观美观度与肿瘤标志物水平影响的研究[J]. 中国医学装备, 2022, 19(8): 104-108. |
| [25] | 常莹, 郭卫宾, 王江芬. 超声引导下乳腺微创旋切术联合循证护理对乳腺癌患者的影响[J]. 现代医学与健康研究电子杂志, 2023, 7(20): 109-112. |
| [26] | Sampathkumar, U., Bui, T., Liu, J., Nowroolizarki, Z., Bordes, M.C., Hanson, S.E., et al. (2022) Objective Analysis of Breast Symmetry in Female Patients Undergoing Breast Reconstruction after Total Mastectomy. Aesthetic Surgery Journal Open Forum, 5, ojac090. https://doi.org/10.1093/asjof/ojac090 |
| [27] | 王玟心, 娄丛坤, 韩宝三. 射频消融治疗早期乳腺癌的研究进展[J]. 临床和实验医学杂志, 2024, 23(2): 222-225. |
| [28] | Schullian, P., Johnston, E., Laimer, G., Putzer, D., Eberle, G., Scharll, Y., et al. (2021) Stereotactic Radiofrequency Ablation of Breast Cancer Liver Metastases: Short and Long-Term Results with Predicting Factors for Survival. Cardio Vascular and Interventional Radiology, 44, 1184-1193. https://doi.org/10.1007/s00270-021-02820-6 |
| [29] | 何小芳, 周敏, 熊朝月, 等. 乳腺癌超声征象及其术后复发的危险因素分析[J]. 东南国防医药, 2022, 24(3): 274-277. |
| [30] | 林珉佳, 查海玲, 张曼琪, 等. 常规超声联合CEUS特征与乳腺癌术后复发转移的相关性分析[J]. 肿瘤影像学, 2024, 33(1): 75-81. |
| [31] | 彭福恢. 乳腺癌术前多模态超声特征与术后复发风险程度的相关性研究[D]: [硕士学位论文]. 哈尔滨: 哈尔滨医科大学, 2022. |
| [32] | 孙雨, 杨琛. 基于自动乳腺超声诊断系统的乳腺肿瘤人工智能诊断研究进展[J]. 中国医学影像学杂志, 2024, 32(11): 1176-1181. |
| [33] | 孙立倩, 王倩. 乳腺癌原位复发灶与术后瘢痕的超声图像分析[J]. 妇儿健康导刊, 2023, 2(14): 22-23. |
| [34] | Divjak, E., Ivanac, G., Radović, N., Biondić Špoljar, I., Sović, S., Bahnik, V., et al. (2020) Second-Look Ultrasound Using Shear-Wave Elastography in MRI-Suspected Locoregional Recurrence of Breast Carcinoma. Ultraschall in der Medizin—European Journal of Ultrasound, 43, 274-279. https://doi.org/10.1055/a-1178-0523 |
| [35] | Bäz, E., Madjar, H., Reuss, C., Vetter, M., Hackelöer, B. and Holz, K. (2000) The Role of Enhanced Doppler Ultrasound in Differentiation of Benign vs. Malignant Scar Lesion after Breast Surgery for Malignancy. Ultrasound in Obstetrics & Gynecology, 15, 377-382. https://doi.org/10.1046/j.1469-0705.2000.00116.x |
| [36] | 张仁容, 钟洁愉, 李平, 等. 乳腺癌肝转移超声表现1例[J]. 临床超声医学杂志, 2022, 24(10): 731-736. |
| [37] | 蔡维玲, 申永春, 文富强. 超声在胸膜疾病诊治中的临床应用进展[J]. 遵义医科大学学报, 2024, 47(7): 736-740. |
