超声造影在浅表淋巴结定性诊断中的临床价值  

The clinical value of contrast-enhanced ultrasound in superficial lymphadenopathy qualitative diagnosis

作　　者：刘青[1] 于铭[1] 苏海砾[1] 韩增辉[1] 宋宏萍[1] 王莉[1] 秦海英[1] 周晓东[1] 

机构地区：[1]第四军医大学西京医院超声科,西安710132

出　　处：《中华超声影像学杂志》2009年第2期142-145,共4页Chinese Journal of Ultrasonography

基　　金：陕西省社发攻关研究计划项目[2007K12-02（4）]

摘　　要：目的探讨超声造影在浅表淋巴结鉴别诊断中的应用价值。方法对94例患者的94个浅表肿大淋巴结进行二维、彩色多普勒超声和超声造影检查，观察其灌注特征，用Philips-Q-LAB软件分析，并与病理诊断结果对照，比较造影前后超声诊断的准确性。结果94例浅表肿大淋巴结经病理诊断确定良性44例，转移性33例，淋巴瘤17例。超声造影诊断的敏感性为84％，特异性为79％，准确性为㈤％。超声造影结果显示，炎性淋巴结在造影后主要表现为均匀显著灌注（39／44），转移性淋巴结主要为不均匀高灌注（25／33）或不均匀低灌注（7／33），淋巴瘤则主要表现为均匀显著灌注（6／17）或整个淋巴结无灌注（9／17）。Q-LAB时间强度定量分析显示良性淋巴结峰值强度及曲线下面积均高于转移性淋巴结和淋巴瘤（P〈0．01）。结论淋巴结造影后的灌注特征和Q—LAB时间强度曲线分析对定性诊断浅表肿大淋巴结疾病提供了有价值的依据。Objective To evaluate the value of contrast-enhanced ultrasound in superficial lyrnphadenopathy. Methods Ninty-four superficial enlarged lymph nodes were studied by 2-dimensional, color Doppler ultrasound, and contrast-enhanced ultrasound. Then the contrast enhanced images were analyzed by Philips Q LAB software. All the results were compared with pathological diagnosis. Results For the 94 superficial lymph nodes examined,44 were benign,33 were metastases and 17 were lymphomas. The sensitivity, specificity, and accuracy of contrast enhanced images were 84 %, 74% and 79 %respectively. Contrast enhanced ultrasound examination showed intense homogeneous enhancement in 39 of 44 benign lymph nodes; high or low homogeneous enhancement in 25 of 33 and 7 of 33 in metastases respectively; intense homogeneous, and scarce enhancement in 6 of 17 and 9 of 17 in lymphomas respectively. Time- intensity curves showed that compared with metastasis lymph nodes and lymphomas, benign lymph nodes had higher peak intensity and larger area under the curve （ P〈0.01 ）. Conclusions The diagnosis accuracy was significant increased when contrast-enhanced ultrasound was test against conventional ultrasound. The character of contrast agent enhancement and Q-LAB time-intensity curves provide valuable diagnosis information for differential diagnosis of benign,metastasis lymph nodes and lymphomas.

关 键 词：超声检查 微气泡 淋巴结 诊断 鉴别 

分 类 号：R686[医药卫生—骨科学]