彩色多普勒超声诊断颈部淋巴结结核的临床价值  

Clinical value of color Doppler ultrasonography in the diagnosis of cervical lymph node tuberculosis

作　　者：高立霓[1] 刘秉彦[1] 莫泽来[1] GAO Li-ni LIU Bing-yan MO Ze-lai.(Department of Ultrasound, People＇s Hospital of Hainan Province, Haikou 570311, Hainan, CHINA)

机构地区：[1]海南省人民医院超声科,海南海口570311

出　　处：《海南医学》2017年第1期102-104,共3页Hainan Medical Journal

摘　　要：目的探讨彩色多普勒超声对颈部淋巴结结核的临床诊断价值。方法回顾分析2014年3月至2016年3月期间我院收治的82例颈部肿大淋巴结患者的临床资料,根据病理诊断结果分为反应性淋巴结(23例)、恶性淋巴结(26例)和淋巴结结核(33例),比较分析不同类型淋巴结的颈部彩色多普勒超声表现。结果颈部淋巴结结核具有一定典型超声征象,17个淋巴结为淋巴结门部血流型,12个淋巴结为边缘型血流,13个淋巴结混合血流型,11个淋巴结内部及周围均未见明显血流信号,血流频谱表现为低阻力型血流。结核性淋巴结及反应性淋巴结的最大血流速度(V_(max))及阻力指数(RI)均显著低于恶性淋巴结,L/S比值显著高于恶性淋巴结,差异均有统计学意义(P<0.05),但结核性淋巴结及反应性淋巴结之间比较差异无统计学意义(P>0.05);结核性淋巴结的边缘型及混合型血流信号所占比例显著低于恶性转移淋巴结,差异均有统计学意义(P<0.05)。结论颈部淋巴结结核具有典型超声特征,配合其他辅助检查对于疾病的早期诊断与鉴别具有重要意义。Objective To explore the clinical value of color Doppler ultrasonography in the diagnosis of cervical lymph node tuberculosis. Methods The clinical data of 82 patients with cervical lymph node tuberculosis in our hospital from March 2014 to March 2016 were retrospectivly analyzed. According to the pathological diagnosis, the patients were divided into reactive lymph node（n=23）, malignant lymph node（n=26）, and lymph node tuberculosis（n=33）.Color Doppler ultrasonography manifestations of different types of lymph nodes were compared. Results Cervical lymph node tuberculosis had certain typical sonographic features, with portal blood flow type in 17 lymph nodes, marginal blood flow type in 12 lymph nodes, mixed blood flow type in 13 lymph nodes, and no obvious blood flow signal in 11 lymph nodes（low resistance flow）. Maximum blood flow velocity（V_（max）） and resistance index（RI） of lymph node tuberculosis and reactive lymph node were significantly lower than those of malignant lymph nodes, but L/S ratios were significantly higher than that of malignant lymph nodes（P0.05）, with no significant differences between tuberculous lymph nodes and reactive lymph nodes（P0.05）. The proportion of marginal blood flow signal and mixed blood flow signal in lymph node tuberculosis was significantly lower than that of malignant lymph node（P0.05）. Conclusion Cervical lymph node tuberculosis has typical features of ultrasound, which combined with other auxiliary examination has important significance for early diagnosis and identification of disease.

关 键 词：颈部淋巴结 淋巴结结核 超声 诊断 

分 类 号：R522[医药卫生—内科学]