能量多普勒血流显像在浅表肿大淋巴结良恶性鉴别诊断中的应用  

Differential diagnosis of benign and malignant superficial enlarged lymph nodes with power Doppler imaging

作　　者：张龙方[1] 段云友[2] 姚克纯[1] 袁丽君[2] 郭蕾[1] 

机构地区：[1]空军总医院超声诊断科,北京100036 [2]第四军医大学唐都医院超声诊断科

出　　处：《临床超声医学杂志》2007年第2期79-82,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的 探讨能量多普勒血流显像用于鉴别浅表良恶性肿大淋巴结的价值。方法 连续观察117例246个浅表肿大淋巴结的血流灌注类型、血管数目、分布及其血流分级。结果反应增生性淋巴结、淋巴结炎表现为中心型灌注血流；淋巴结结核与转移淋巴结相似，多为周边型灌注；被淋巴瘤侵入的淋巴结呈高灌注，在中心及周边均可有彩色血流显示。良性肿大淋巴结所显示的血管外形多粗细均匀、平直，分支少，走行规则、对称，血流分级0～Ⅱ级；而恶性肿大淋巴结所显示的血管外形多粗细不均、杂乱，分支多，走行移位、扭曲，血流分级Ⅱ～Ⅲ级。结论 能量多普勒血流显像更适合观察浅表肿大淋巴结内部血流。结合血流灌注类型、分布形态及其血流分级，更能准确完整地显示浅表肿大淋巴结的血流特征，有助于良恶性的鉴别诊断，但存在部分交叉。Objective To assess the value of PDI in distinguishing benign from malignant superficial enlarged lymph nodes. Methods Two hundred and forty-six enlarged lymph nodes, involving internal and peripheral blood perfusion types, distribution, and the number of blood vessels and the gradation of blood flow were observed with PDI. Results Lymphnoditis and reactive hyperplasy lymph node showed the central perfusion, the distribution of metastatic lymphnodes and tuberculous lymphaden showed high peripheral peffusion. The lymph nodes were invaded by malignant lymphoma exhibited high perfusion, and there are colorful blood flow in center and peripheral. The blood flow in benign enlarged lymph nodes exhibited in regular shape,and its blood grade was 0 to Ⅱ; The blood distribution of malignant lymph nodes exhibited malposition, deformation disorder and distortion with Ⅱ to Ⅲ grade blood flow. Conclusion PDI was more appropriate to observe the inner blood flow of superficial enlarged lymph nodes. It was more accurate and complete to display the blood flow characteristics of superficial enlarged lymph nodes, combined blood flow perfusion types with the gradation of blood flow. It was a valuable method for aid in the differential diagnosis of benign and malignant lymph nodes, but it hane partial overlap.

关 键 词：淋巴结 鉴别 能量多普勒显像 

分 类 号：R445.1[医药卫生—影像医学与核医学]