头颈部淋巴结病变超声造影时间-强度曲线的分析  

Time-intensity curve of contrast-enhanced ultrasound applied for differentiation of malignant from benign cervical lymph nodes

作　　者：李江萍[1] 冀鸿涛[1] 朱强[1] 马腾[1] 赵汉学[1] 

机构地区：[1]首都医科大学附属北京同仁医院超声医学科,北京100730

出　　处：《首都医科大学学报》2014年第2期184-188,共5页Journal of Capital Medical University

摘　　要：目的评价头颈部淋巴结超声造影(contrast-enhanced ultrasound,CEUS)时间-强度曲线(time-intensity curve,TIC)参数在良、恶性病变鉴别诊断中的价值。方法对85名头颈部淋巴结病变的患者(85枚淋巴结,良恶性各为36枚和49枚)进行CEUS。设置感兴趣区(region of interest,ROI)于整个淋巴结、皮质最明显增强区、皮质最弱或无增强区、髓质-门区域、周围软组织。对获得的TIC参数(基础强度、峰值强度、上升支斜率、始增时间、达峰时间、上升时间、峰值浓度减半时间、平均渡越时间)进行分析比较。通过对皮质最明显增强区的上升时间接收者操作特征曲线(receiver operating characteristic curve,ROC)分析,计算出诊断良恶性淋巴结的界值(cut off value)。结果恶性淋巴结在皮质最明显增强区的上升时间明显短于良性淋巴结(P=0.041)。结论 ROI设置于皮质最明显增强区域时TIC的上升时间对头颈部淋巴结良恶性病变的鉴别诊断具有重要意义。Objective To evaluate the value of the time-intensity curve （ TIC ） of contrast-enhanced ultrasound （ CEUS ） in differentiation of malignant from benign lymph nodes of the head and neck. Methods Eighty-five patients with enlarged cervical lymph nodes（85 lesions） were examined with CEUS. Of 85 nodes, 36 benign and 49 malignant lesions were proved histopathologically. Region of interest（ ROI） was placed in whole lymph nodes, the most evident enhanced area of the cortex, the weakest enhanced area of the cortex, medulla-hilar area, and soft tissue next to the node, respectively. Eight TIC parameters（ basic intensity, peak intensity, wash in slope, arrival time, time to peak, rise time, time from peak to one half, and mean transit time） were compared between malignant and benign nodes. Finally the malignant lymph nodes were evaluated by the ROC curve drawn with the rise time, and meanwhile the cut off value was obtained. Results The rise time of ROI that was placed on the most evidently enhanced area of the cortex of cervical lymph nodes was significantly shorter in malignant than benign lesions（P=0. 041）. Conclusion The rise time value obtained from most evidently enhanced areas of the lymph node cortex could help differentiate malignant from benign nodes of the head and neck.

关 键 词：淋巴结 头颈部 超声诊断 超声造影 时间-强度曲线 

分 类 号：R445.1[医药卫生—影像医学与核医学]