超声造影定性与定量分析诊断颈部浅表淋巴结病变的研究  

Qualitative and quantitative analysis of contrast-enhanced ultrasonography in the diagnosis of superficial cervical lymphadenopathy

作　　者：吴仕吉 邱娅[1] 努尔艾力·木台力甫 范明江 马爱琳[1] 刘环[1] WU Shi-ji;QIU Ya;Nur Aili·Mutailifu;FAN Ming-jiang;MA Ai-lin;LIU Huan(Department of Ultrasonography, the First People′s Hospital of Kashgar, Xinjiang Uygur Autonomous Region, Kashgar 844000, China)

机构地区：[1]新疆维吾尔自治区喀什地区第一人民医院超声医学科,新疆喀什844000

出　　处：《河北医科大学学报》2021年第4期429-434,共6页Journal of Hebei Medical University

基　　金：“天山青年计划”之基层青年科技人才培养项目(2018Q141)。

摘　　要：目的超声造影定性与定量分析诊断颈部浅表淋巴结病变的价值。方法前瞻性选取颈部浅表淋巴结肿大患者50例作为研究对象,在超声造影引导下进行细针穿刺活检,分别采用超声造影定性与定量分析诊断颈部浅表淋巴结病变,比较超声造影定性与定量分析诊断颈部浅表淋巴结良恶性病变的价值。结果病理诊断显示,50例患者中良性淋巴结17例,恶性淋巴结33例。超声引导下细针穿刺检查结果与手术病理检查结果一致性较强(Kappa值=0.868,P<0.05)。良性淋巴结和恶性淋巴结的造影灌注模式、病灶增强特点、边界清晰度、病灶达峰强度分级差异均有统计学意义(P<0.05)。良性组达峰时间(time to peak,TP)、峰值强度(peak intensity,PI)、平均渡越时间(timefrom peak to one half,mTT)值明显短于或小于恶性组,差异有统计学意义(P<0.05),2组速度参数(β)值差异无统计学意义(P>0.05)。受试者工作曲线(receiver operator characteristics curve,ROC)分析显示,定量分析结果诊断恶性颈部浅表淋巴结的AUC为0.829;定性分析结果诊断恶性颈部浅表淋巴结的AUC为0.939。根据最佳临界值,当定量分析结果低于85.44时,其敏感度为84.8%,特异度为82.4%,而当定性分析结果低于3.51时,其敏感度为90.9%,特异度为82.4%。结论超声引导下细针穿刺检查结果与手术病理检查结果一致性较强,超声造影定性分析对颈部浅表淋巴结良恶性病变的诊断价值略优于定量分析,且均在诊断颈部浅表淋巴结病变上提供了有价值的依据。Objective To analyze the value of qualitative and quantitative analysis of contrast-enhanced ultrasonography in the diagnosis of superficial cervical lymphadenopathy.Methods For this prospective study,a total of 50 patients with superficial cervical lymphadenopathy were prospectively selected as the research subjects,and fine-needle aspiration biopsy was performed under the guidance of contrast-enhanced ultrasonography.The qualitative and quantitative analysis of contrast-enhanced ultrasonography was used to diagnose the superficial lymph node lesions in the neck.The value of qualitative and quantitative analysis of contrast-enhanced ultrasonography in diagnosing benign and malignant lesions of superficial lymph nodes in the neck was compared.Results Pathological diagnosis showed that among the 50 patients,17 had benign lymph nodes and 33 had malignant lymph nodes.The results of ultrasound-guided fine-needle aspiration examination were consistent with surgical and pathological examination results(Kappa=0.868,P<0.05).There were statistically significant differences in the contrast-enhanced perfusion pattern,lesion enhancement characteristics,boundary definition,and peak intensity grading of benign and malignant lymph nodes(P<0.05).The time to peak(TP),peak intensity(PI),and mean transit time(mTT)values of the benign group were significantly shorter or smaller than those of the malignant group,and the difference was statistically significant(P<0.05).No significant difference was found in the speed parameter(β)value between the two groups(P>0.05).Receiver operator characteristics curve(ROC)curve analysis showed that the AUC for the diagnosis of malignant superficial cervical lymph nodes by quantitative analysis and qualitative analysis was 0.829 and 0.939 respectively.According to the optimal cut-off value,when the quantitative analysis result was lower than 85.44,the sensitivity and specificity were 84.8%and 82.4%respectively;when the qualitative analysis result was lower than 3.51,the sensitivity and specificity

关 键 词：浅表淋巴结病变 超声造影 诊断 

分 类 号：R632.6[医药卫生—外科学]