超微血管显像技术在鉴别诊断淋巴结良恶性中的应用  

Application of superb microvascular imaging in differential diagnosis of benign and malignant lymph nodes

作　　者：金佳美[1] 詹嘉[1] 刁雪红[1] 柴启亮[1] 王海尔[1] 陈悦[1] 

机构地区：[1]复旦大学附属华东医院超声科,上海200040

出　　处：《中国医学影像技术》2015年第12期1825-1829,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨超微血管显像（SMI）技术对淋巴结良恶性鉴别诊断的临床应用价值。方法回顾分析62例浅表淋巴结肿大患者的超声检查资料,并与病理结果对照,比较二维灰阶超声联合CDFI、二维灰阶超声联合SMI及CEUS鉴别诊断良性淋巴结、淋巴瘤及恶性肿瘤淋巴转移的准确率。并以CEUS为金标准,分析淋巴结内微血管分布类型。结果62例患者共76枚浅表肿大淋巴结,其中良性淋巴结21枚,淋巴瘤32枚,恶性肿瘤淋巴结转移23枚。二维灰阶超声联合SMI与CEUS的诊断准确率均高于二维灰阶超声联合CDFI（χ^2=7.91、14.04,P=0.021、0.005）,而二维灰阶超声联合SMI与CEUS间差异无统计学意义（χ^2=0.31,P〉0.05）。CDFI及SMI与CEUS对淋巴结内微血管分布类型的一致性均较高（Kappa=0.672、0.793）。结论 SMI与CEUS对判断淋巴结内微血管分布类型具有较高的一致性,有助于提高浅表肿大淋巴结定性诊断的准确率。Objective To assess the clinical value of superb microvascular imaging（SMI） tor differential diagnosis of benign and malignant lymph nodes.Methods Ultrasonic and pathological data of 76 enlarged lymph nodes in 62 patients were retrospectively analyzed.The accuracy of two-dimensional gray-scale ultrasonography combined with CDFI,two-dimensional gray-scale ultrasonography combined with SMI and CEUS in differential diagnosis of benign lymph nodes,lymphadenomas and metastatic lymph nodes were compared.Moreover,taking CEUS results as the gold standard,the microvascular distributions in lymph nodes obtained by CDFI and SMI were studied.Results Among 76 enlarged lymph nodes,there were 21 benign lymph nodes,32 lymphadenomas and 23 metastatic lymph nodes.The diagnostic accuracy of gray-scale ultrasonography combined with SMI and CEUS was respectively higher than that of gray-scale ultrasonography combined with CDFI（χ^2=7.91,14 04;P = 0.021,0.005）.There was no statistical difference of diagnostic accuracy between grayscale ultrasonography combined with SMI and CEUS（χ^2=0.31,P〉0.05）.There was moderate agreement between the microvascular distributions in lymph nodes obtained by CEUS and CDFI（Kappa = 0.672）,while moderate agreement was also found between CEUS and SMI（Kappa = 0.793）.Conclusion SMI and CEUS has higher agreement for the detection of microvascular distributions.And SMI is helpful in promoting the accuracy of differential diagnosis of benign and malignant lymph nodes.

关 键 词：淋巴结 超微血管显像 超声检查 微泡 

分 类 号：R733.4[医药卫生—肿瘤] R445.1[医药卫生—临床医学]