高频超声鉴别良恶性浅表淋巴结的应用价值  

Evaluation of high frequency ultrasound in the diagnosis of enlarged superficial lymph nodes

作　　者：杨先[1] 程文[1] 孙一欣[1] 张丹丹[1] 郭丹阳[1] 

机构地区：[1]哈尔滨医科大学附属第三医院超声科,哈尔滨150081

出　　处：《中华医学超声杂志（电子版）》2011年第10期2171-2178,共8页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨高频超声对浅表肿大淋巴结良恶性鉴别诊断的临床应用价值。方法对2009年12月至2010年12月在我院进行高频超声检查的浅表淋巴结肿大的患者384例,观察肿大淋巴结的二维超声声像图及血流动力学特点,所有病例均经超声引导下穿刺活检,根据组织学病理结果分为良性淋巴结组和恶性淋巴结组,分析两组超声声像图的不同特点。结果良性淋巴结组118例(其中淋巴结炎44例,淋巴结核40例,反应性增生淋巴结34例),恶性淋巴结组266例(恶性淋巴瘤33例,转移性淋巴结233例),高频彩色超声诊断准确率为89.06%(342/384)。恶性淋巴结组淋巴结的长径值及短径值为(3.3±1.4)cm、(1.9±1.2)cm,良性淋巴结组淋巴结的长径值及短径值为(2.1±1.3)cm、(1.1±0.5)cm,两者差异有统计学意义(t=10.601、9.298,P均<0.001);淋巴结长短径比值(L/S)<2(恶性淋巴结组占81.30%,良性淋巴结组占23.90%,χ2=210.10,P<0.001)及淋巴结内血流阻力指数(RI)恶性淋巴结组为0.74±0.16,良性淋巴结组为0.62±0.21,两者差异均有显著统计学意义(t=8.011,P<0.001)。结论高频彩色多普勒超声对浅表肿大淋巴结良恶性的诊断具有重要的临床价值,可作为鉴别诊断的首选方法。Objective To investigate the value of high frequency ultrasound in the diagnosis of superficial lymph nodes.Methods Three hundred and eighty-four cases of superficial tumescent lymph nodes were scanned by high frequency ultrasound in our department from December 2009 to December 2010,in order to observe the characteristics of two-dimensional images and color Doppler flow imaging of them.Ultrasound-guided biopsy were performed to all cases.The lymph nodes were divided into the benign group and the malignant group according to pathologic reports.The differences of the two groups were analysed,and statistical analysis was performed.Results One hundred and eighteen cases were benign including 44 cases of lymphadenitis,40 cases of tuberculosis lymphadenitis,and 34 cases of nonspecific lymphadenectasis.A total of 266 cases were malignant including 33 cases of malignant lymphoma and 233 cases of metastatic lymphadenectasis.The diagnostic accuracy of high frequency ultrasound was 89.06%(342/384).Long diameter and short diameter of lymph nodes in the malignant group were(3.3 ±1.4),(1.9 ±1.2)cm,and(2.1 ±1.3),(1.1 ±0.5)cm in the benign group.There were statistically differences between the two groups(t=10.601,9.298,both P<0.001);lymph nodes L/S<2(the malignant group 81.30% vs the benign gruoup 23.90%;χ2=210.10,P<0.001)and vascular resistance index(RI)of the malignant group were higher than the benign group,and the differences between the two groups were statistically significant(the malignant group 0.74±0.16 vs the benign group 0.62±0.21;t=8.011,P<0.001).Conclusions Superficial high frequency ultrasound plays an important role in diagnosing benign and malignant lymph nodes.It can be used as the preferred method of differential diagnosis.

关 键 词：超声检查 浅表淋巴结 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]