ObjectiveTo evaluate the diagnostic value of contrast enhanced ultrasound (CEUS) to the sentinel lymph node (SLN) of breast cancer. MethodsSeventy-two operable breast cancer patients with clinically negative axillary lymph node were enrolled.Sulphur hexafluoride microbubbles for injection (SonoVue) was used alone as the tracer agent for the sentinel lymph node biopsy (SLNB), and axillary dissection was performed after the methylene blue location.All SLNs were examined pathologically with HE staining.The SLN diagnosis result of contrast enhanced ultrasound and postoperative pathological examination result were comparative analyzed. ResultsAfter the injection of SonoVue can obtain a clear image of the lymphatic vessels and SLN.The success rate of CEUS imaging was 84.72% (61/72) in this group of 72 patients, and the false negative rate was 12.12% (4/33).The sensitivity and specificity of diagnosis by CEUS was 92.50% (37/40) and 92.59% (50/54), respectively, the diagnostic odds ratio (DOR) was 154.17.By the pathology results as the gold standard, the internal consistency of these two methods was good (Kappa value=0.848, P < 0.01). ConclusionCEUS may be a useful orientation and determination method for SLNs.
ObjectiveTo systematically review the value of intra-operative ultrasound in diagnosis of tumor residue after resection of intracranial gliomas. MethodsSuch databases as PubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP were electronically searched for the diagnostic test about intra-operative ultrasound in diagnosis of tumor residue after resection of intracranial gliomas by March 31st, 2013. Meanwhile, search engines such as Google, Baidu were also used for relevant search. According to the inclusion and exclusion criteria, the literature was screened and the data were extracted. The methodological quality was evaluated in accordance with the quality assessment tool for diagnostic accuracy studies (QUADAS) and then meta-analysis was conducted using Meta-DiSc 1.4 software. ResultsA total of 10 studies involving 423 patients were included. The results of meta-analysis showed that the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio (DOR) were 0.78 (95%CI 0.74 to 0.82), 0.90 (95%CI 0.88 to 0.90), 5.12 (95%CI 2.86 to 9.16), 0.29 (95%CI 0.21 to 0.39) and 25.00 95%CI (13.27 to 47.10), respectively; and the AUC was 0.89. In the subgroup analysis, for low grade intracranial gliomas, the results of meta-analysis showed that the sensitivity, specificity and DOR were 0.87 (95%CI 0.77 to 0.94), 0.88 (95%CI 0.78 to 0.94) and 28.93 (95%CI 7.46 to 112.14), respectively, and the AUC was 0.92. For high grade gliomas, the results of meta-analysis showed that the sensitivity, specificity and DOR were 0.80 (95%CI 0.72 to 0.87), 0.67 (95%CI 0.53 to 0.79) and 7.20 (95%CI 3.04 to 17.09), respectively, and the AUC was 0.80. ConclusionIntra-operative ultrasound is useful for the diagnosis of tumor residue after resection of intracranial gliomas, especially for low grade gliomas.