实时剪切波弹性成像在评价浅表淋巴结疾病中的应用研究  

Application of Real-time Shear Wave Elastography in Evaluating Superficial Lymph Node Disease

作　　者：王颖[1] 郝霁萍 姜珏[1] 朱照 周琦[1] Wang Ying;Hao Jiping;Jiang Jue;Zhu Zhao;Zhou Qi(Department of UItrasound,the Second Affliated Hospital of Xi an Jiaotong University,Xi'an,Sheanxi 710004,China;Department of Ultrasound,Ninth Hospital of Xi'an,Xi'an,Shaanxi 710054,China)

机构地区：[1]西安交通大学第二附属医院超声医学研究室,西安市710004 [2]西安市第九医院超声医学科,西安市710054

出　　处：《中国超声医学杂志》2021年第4期432-435,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的对浅表肿大淋巴结进行SWE,通过定量指标找出各淋巴结疾病的诊断阈值、评价应用Emean值鉴别良恶性淋巴结的诊断效能。方法对227个淋巴结进行常规超声检查,再进行SWE,并测量淋巴结弹性模量值,将其分为良性组(反应增生性淋巴结、结核性淋巴结)、恶性组(淋巴瘤、转移性淋巴结);对各类型淋巴结的Emean值进行统计分析,找出良恶性淋巴结的诊断阈值并绘ROC曲线。结果反应增生性淋巴结(12.49±6.56)kPa、结核性淋巴结(22.83±8.5)kPa、淋巴瘤(29.53±14.88)kPa及转移性淋巴结(52.6±34.84)kPa的Emean值不来自同一总体,组间具有可比性;四组淋巴结疾病诊断阈值分别为:15.75、17.85、25.90、32.35 kPa;良恶性淋巴结之间,以25.9 kPa为诊断界值时,Emean值鉴别诊断的灵敏度为84.6%、特异度为87.5%。结论 SWE的Emean值可以为浅表淋巴结疾病诊断提供依据,同时可得出良恶性淋巴结最佳诊断阈值,具有重要临床价值。Objective SWE was carried out on superficial enlarged lymph nodes, and the diagnostic threshold value of each lymph node disease was found by quantitative indexes, and the diagnostic efficacy of Emean value in differentiating benign and malignant lymph nodes was evaluated. Methods Routine ultrasound examination was performed on 227 lymph nodes, followed by SWE, and the elastic modulus of lymph nodes was measured. The lymph nodes were divided into benign group(reactive proliferative lymph nodes, tubercular lymph nodes) and malignant group(lymphoma, metastatic lymph nodes).The Emean values of each type of lymph node were analyzed statistically to find out the diagnostic threshold of benign and malignant lymph nodes and draw the ROC curve. Results Emean values of reactive proliferative lymph node(12.49±6.56)kPa, tuberous lymph node(22.83±8.5)kPa, lymphoma(29.53±14.88)kPa and metastatic lymph node(52.6±34.84)kPa were not from the same population, and were comparable between groups.The diagnostic thresholds of lymph node diseases in the four groups were 15.75 kPa, 17.85 kPa, 25.90 kPa and 32.35 kPa, respectively.When 25.9 kPa was used as the diagnostic threshold between benign and malignant lymph nodes, the sensitivity and specificity of Emean value were 84.6% and 87.5% respectively. Conclusions The Emean value of SWE can provide a basis for the diagnosis of superficial lymph node diseases and obtain the optimal diagnostic threshold of benign and malignant lymph nodes, which has important clinical value.

关 键 词：浅表淋巴结 剪切波弹性成像 定性分析 定量分析 

分 类 号：R445.1[医药卫生—影像医学与核医学] R551.2[医药卫生—诊断学]