超声造影在浅表淋巴结疾病鉴别诊断中的应用研究  

Contrast-enhanced ultrasound for evaluation of superficial lymphadenopathy

作　　者：洪玉蓉[1] 刘学明[1] 张闻[1] 莫国强[1] 许俊[1] 魏红权[2] 

机构地区：[1]浙江大学医学院附属第二医院超声科,杭州310009 [2]浙江大学医学院附属第二医院病理科,杭州310009

出　　处：《中华超声影像学杂志》2006年第11期849-852,共4页Chinese Journal of Ultrasonography

基　　金：浙江省科技厅(2005C33001);浙江省卫生厅(2005B13069)基金资助项目

摘　　要：目的探讨超声造影在浅表淋巴结疾病鉴别诊断中的应用价值。方法对43例患者的75个浅表肿大淋巴结(良性28个,转移性39个,淋巴瘤8个)进行常规二维、彩色多普勒超声检查和灰阶超声造影,观察淋巴结造影剂灌注特征,并与病理对照,比较造影前后超声诊断的准确性。结果良性淋巴结中57%(16/28)造影表现为均匀增强型,36%(10/28)表现为淋巴门不均匀增强型;转移性淋巴结中77%(30/39)表现为实质不均匀增强型,21%(8/39)表现为微弱增强型。常规超声诊断良恶性淋巴结的敏感性70%,特异性86%,准确性75%;超声造影诊断的敏感性87%,特异性93%,准确性89%,超声造影诊断的准确率显著提高(P<0.05)。结论灰阶超声造影发现淋巴结疾病的不同灌注特征,为良恶性淋巴结疾病的鉴别诊断提供了有价值的依据。Objective To evaluate the value of contrast-enhanced ultrasound in differential diagnosis of superficial lymphadenopathy. Methods Seventy-five lymph nodes from 43 patients were studied both by conventional techniques and contrast-enhanced ultrasound. Of the lymph nodes examined, 28 were benign and 47 were malignant（39 metastases and 8 non-Hodgkin lymphomas）. The enhancement of echogenicity was evaluated. The diagnosis obtained by means of surgical biopsy. Results The study using contrast enhanced ultrasound showed intense homogeneous enhancement in 16 of 28 （57%） benign lymph nodes; intense but inhomogeneous enhancement in 11） of 28（36%） benign lymph nodes, with perfusion defects in the echogenic hilum; intense but inhomogeneous enhancement in 311 of 39（77%） metastases, with perfusion defects in the nodal parenchyma; and last, scarce intranodal enhancement in 8 of 39（21%） metastases. The sensitivity, specificity, and accuracy of conventional techniques in differentiation between benign and malignant lymph nodes were 70%, 86%, and 75% versus 87%, 93%, and 89% for contrast-enhanced ultrasound. The increase in correct diagnosis was significiant（ P （0.05） when conventional ultrasound was tested against contrast-enhanced ultrasound. Conclusions Enlarged superficial lymph nodes can be characterized as benign or malignant with high diagnosis accuracy on the basis of enhancement of echogenicity as seen on contrast-enhanced ultrasound.

关 键 词：超声检查 造影剂 淋巴系统疾病 淋巴结 

分 类 号：R445.1[医药卫生—影像医学与核医学]