实时剪切波弹性成像评价颈部及腋窝淋巴结硬度  

Evaluation on the stiffness of cervical and axillary lymph nodes with real-time shear wave elastography

作　　者：程慧芳[1] 王学梅[1] 李银燕[1] 姜镔[1] 陶春梅[1] 张义侠[1] 

机构地区：[1]中国医科大学附属第一医院超声科,辽宁沈阳110001

出　　处：《中国医学影像技术》2015年第3期363-366,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨应用剪切波弹性成像(SWE)技术测定的颈部及腋窝淋巴结弹性模量值鉴别诊断正常与恶性淋巴结的价值。方法选取经穿刺活检或手术证实颈部及腋窝恶性淋巴结患者72例以及80名正常人,分别纳入恶性及正常浅表淋巴结各100个,其中颈部淋巴结各60个,腋窝淋巴结各40个,于术前进行实时剪切波弹性成像,获取淋巴结弹性模量值,分析比较颈部及腋窝正常、恶性淋巴结间弹性值的差异;以病理结果为"金标准",分别绘制并分析采用颈部、腋窝淋巴结弹性模量平均值诊断恶性淋巴结的ROC曲线,评价诊断效能。结果颈部正常淋巴结的弹性模量平均值为(18.94±5.20)kPa,恶性淋巴结为(25.48±5.36)kPa,腋窝正常淋巴结的弹性模量平均值为(11.68±2.27)kPa,恶性淋巴结为(19.71±3.93)kPa,颈部正常、恶性淋巴结的弹性模量平均值均分别高于腋窝正常、恶性淋巴结(P均<0.01),同一部位(颈部、腋窝)的恶性淋巴结弹性平均值均高于正常淋巴结(P均<0.01)。应用颈部淋巴结弹性模量平均值诊断恶性淋巴结,ROC曲线下面积(AUC)为0.81,以19.15kPa为诊断界值时,敏感度为93.3%,特异度为65.0%。应用腋窝淋巴结弹性模量平均值诊断恶性淋巴结,AUC为0.98,以13.95kPa为诊断界值时,敏感度为97.5%,特异度为87.50%。结论SWE弹性模量平均值可以为颈部及腋窝正常与恶性淋巴结的鉴别诊断提供依据。Objective To explore the value of Young＇s modulus of cervical and axillary lymph nodes in differential diagnosis of normal and malignant lymph nodes using shear wave elastography（SWE）.Methods Totally 72 patients with malignant lymph nodes confirmed by pathology and eighty volunteers were enrolled in this study,both including 100 superficial lymph nodes（60 cervical lymph nodes and 40 axillary lymph nodes）.All of them underwent SWE and the Young＇s modulus of cervical lymph nodes and axillary lymph nodes were compared before biopsy or operation.All lymph nodes were performed biopsy or operation,and then the pathological results were regarded as ＂gold standard＂,ROC curve for differential diagnosis of normal and malignant lymph nodes using Young＇s modulus and diagnostic efficiency was analyzed.ResultsThe mean of Young＇s modulus of normal cervical lymph nodes was lower than that of malignant lymph nodes（[18.94±5.20]kPa vs[25.48±5.36]kPa,P〈0.01）,as well as the axillary lymph nodes（[11.68±2.27]kPa vs [19.71±3.93]kPa,P〈0.01）.The mean of Young＇s modulus of normal cervical lymph nodes was higher than that of axillary lymph nodes,as well as the malignant lymph nodes（both P〈0.01）.The area under the curve（AUC）for cervical and axillary lymph nodes was 0.81 and 0.98,taking 19.15 kPa and 13.95 kPa as the cut-off values of mean Young＇s modulus,and the diagnostic sensitivities was 93.3% and 97.5%,the specificities was 65.0% and 87.5%,respectively.Conclusion The mean of Young＇s modulus of cervical and axillary lymph nodes by SWE is helpful for differential diagnosis of normal and malignant lymph nodes.

关 键 词：淋巴结 弹性成像技术 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R322.25[医药卫生—诊断学]