超声评价头颈部肿瘤患者颈部转移性淋巴结特征  

Ultrasound Features of Metastatic Lymph Nodes in Patients with Head and Neck Carcinoma

作　　者：曾乐凤[1] 熊屏[1] 徐秋华[1] 杨功鑫 方早[1] 田臻[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院超声诊断科,上海市200011

出　　处：《中国超声医学杂志》2016年第11期964-966,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨头颈部肿瘤患者头颈部转移性淋巴结(MLN)的灰阶超声特征,以及归纳最具MLN指向性的特征。方法筛选经术后病理证实有颈部MLN的头颈部肿瘤患者(121例,168个MLN)的术前淋巴结二维超声检查结果,对照病理结果分为真阳性组(114个)及假阴性组(54个)。分析5个特征:形状(规则或不规则)、最短径(>10mm或≤10mm)、纵横比(长轴与短轴的比值)、淋巴门(清晰或不清晰)、内部回声(均匀与不均匀)。结果在真阳性组MLN中,104(91%)个为规则形态,60(53%)个最短径>10 mm,106(93%)个缺失淋巴门,87(76%)个纵横比值<2,82(72%)个内部回声不均匀。在假阴性组中,54(100%)个均为规则形态及均匀的内部回声,50(53%)个最短径≤10mm,50(93%)个淋巴门清晰,39(72%)个纵横比值≥2。结论淋巴门的缺失,纵横比<2,内部回声不均匀是MLN的主要特征。最短径>10mm具有较小指向价值。Objective To characterize ultrasound features of metastatic lymph nodes （MLN） in patients with head and neck carcinoma and determine which of the characteristics were most predictive of MLN. Methods US was performed on histologically proven metastatic cervical lymph nodes （121 patients, 168 nodes） before surgery, and the nodes were then classified into the true-posifive group （114 nodes） and false-negative group （54 nodes）. Five characteristic features were assessed, shape, short-axis diameter, aspect ratio, hilum and echogenicity. Results In the truepositive group, 104 （91%） ,nodes were regular in shaper 60 （53%）〉10 mm in short axis, 106 （93%） absent in hilum, 87 （76%）〈2 in aspect ratio, 82 （72%） inhomogeneous in echogenieity respectively. In the false-negative group, 54 （100%）,nodes were regular in shape, had homogeneous echogenicity, 50 （53%）≤10 mm in short axis, 50 （ 93 % ） present in hilum, 39 （72 %） ≥2 For the aspect ratio severally. Conclusions： An absence of hilar echoes, aspect ratio of less than 2 and inhomogeneous echogenieity were major predictive indicators of MLN. The short axis criteria of 〉10 mm had less predictive value.

关 键 词：头颈部肿瘤 转移 颈部淋巴结 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.91[医药卫生—诊断学]