常规超声联合超声造影对颈部淋巴结的定性诊断价值  

Value of conventional ultrasound combined with contrast-enhanced ultrasound in qualitative diagnosis of cervical lymph nodes

作　　者：彭晓琼[1] 涂波[1] 刘丽萍[1] 李茂萍[1] 蒲大容[1] 

机构地区：[1]重庆医科大学附属第一医院超声科,重庆400016

出　　处：《重庆医学》2016年第9期1216-1219,共4页Chongqing medicine

摘　　要：目的探讨常规超声联合超声造影检查在颈部良、恶性淋巴结定性诊断中的价值。方法对112例(129枚)颈部淋巴结进行二维、彩色多普勒超声和灰阶超声造影检查,根据病理结果分为良性和恶性两组,比较两组淋巴结的纵横比、髓质是否偏心或消失、回声类型、血供分布、造影增强模式及造影剂分布均匀度等超声指标。结果良性组纵横比多大于或等于2,皮质和髓质均匀对称性增大,无微小钙化,血供分布多为门型和无血流型,造影多为淋巴门和髓质先增强,呈离心性充盈;恶性组纵横比多小于2,髓质偏心或消失,部分淋巴结实质呈高回声,伴有囊性变和微小钙化,血供以混合型和边缘型血流为主,造影多呈非淋巴门和髓质先增强模式。两组间上述超声指标比较,差异均有统计学意义(P<0.05);其中非淋巴门和髓质先增强模式诊断恶性淋巴结的灵敏度和准确率最高,各项指标的阳性预测值也较高,但阴性预测值较低。结论常规超声联合超声造影检查对颈部淋巴结的定性诊断具有较高实用价值;多个指标综合判断可以提高对颈部良、恶性淋巴结的鉴别能力。Objective To investigate the value of conventional ultrasound combined with contrast-enhanced ultrasound in qualitative diagnosis of benign and malignant cervical lymph nodes（LNs）.Methods Totally 129 enlarged LNs in 112 cases were performed the 2-dimensional,color Doppler ultrasound,and grey-scale contrast-enhanced ultrasound（CEUS）examinations.LNs were divided into the benign group and malignant group according to pathologic results.The aspect ratio,eccentric medulla or medulla defect,echo type,blood supply distribution,contrast-enhancement pattern and distribution equilibriuym of contrast agent were compared between the two groups.Results The most of aspect ratio in the benign LNs group were≥ 2,the cortex and medulla were uniform with symmetric increase and without microcalcification,the blood supple was mainly the non-blood flow type or hilar type,in contrast-enhanced ultrasound,the majority were the early hilar and medullar enhancement,showing the centrifugally full filling;the most of aspect ratio in the malignant LNs group were〈2,medulla was eccentric or loss,partial of LNs showed the increased parenchymal echo accompanied with cystic lesion and microcalcification,the blood supply was mainly the peripheral and mixed types,and the non-hilar and medulla started enhancement pattern.The ultrasonographic parameters mentioned above were statistically different between the two groups,in which the non-hilar and medulla started enhancement patterns had the highest sensitivity and accuracy for diagnosing malignant LNs,the positive predictive values of these parameters were higher,whereas the negative predictive values were lower.Conclusion The conventional ultrasound combined with contrast-enhanced ultrasonography has a higher practical value in qualitative diagnosis of cervical LNs;the comprehensive judgment of multiple indicators can increase the differentiating ability for benign from malignant LNs.

关 键 词：常规超声 超声造影 淋巴结 定性诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]