浅表淋巴结病变彩色超声检查的临床应用  

Diagnosis of Benign and Malignant Superficial Lymphadenopathy Using Conventional and Color Doppler Sonography

作　　者：侯新燕[1] 张武[1] 

机构地区：[1]北京医科大学张三医院超声科

出　　处：《中国超声医学杂志》1996年第S1期38-42,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：本文共检查６７例，２３７个肿大浅表淋巴结（良性１４０个，恶性９７个）。全部病例经超声引导穿刺和／或手术活检病理证实。同期选择健康者３０例，１２０个颈部淋巴结为对照组。结果表明，正常淋巴结的２Ｄ、ＣＤＩ表现及ＰＷ参数与异常淋巴结相比差别显著；正常淋巴结短径≤０．５ｃｍ是一个重要的鉴别指标。在异常淋巴结中，良恶性淋巴结的２Ｄ表现如皮质、髓质和门部的改变以及诸测量参数如Ｌ、Ｓ、Ｌ／Ｓ比值等具有各自的特性。但仍具有其局限性，尤以结核性易与恶性病变相混淆。ＣＤＩ和ＤＰＩ显示良性淋巴结与恶性淋巴结具有显然不同的血流分布形态，结合ＰＷ参数中Ｖｍａｘ和ＲＩ有助于进一步区分淋巴结的良恶性病变。SixiY-seven patients'237 superficial lymph nodes lesions suspected were evaluated by 2-Dimensional ultrasound arid color Doppler sonography(CDI,DPI,PW).All the patients accepted biopsy and/or surgery and had pathologic results.140 benign and 97 malignant lymph nodes were found.There were 120 normal cervical lymph nodes in 30 healthy people as a control group.Results showed that differentiation of normal and abnormal superficial lymph nodes were facilitated by using high-resolution US.The short axis of lymph node with≤5 mm in diameter showed high sensitivity,specificity and accuracy for diagnosing normal lymph node.It also showed that some different sonomorphologic features of lymph nodes existed in benign and malignant groups,such as the measurements of long axis,short axis and L/S ratio;and echotexture changes of their cortex,medulla hilus.Hower,these findings did have some limitations in differential diagnosis,especially between tuberculous and malignant lesion. We found that by using CDI,DPI combined with specturm analysis of PW Doppler,some different blood flow patterns and hemodynamic parameters such as maximal systolic flow velocities and resistance index were helpful for making further differential diagnosis.

关 键 词：彩色多普勒超声 淋巴结 肿瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学]