高帧率超声造影对颈部浅表淋巴结病变良恶性的鉴别诊断  

High Frame Rate Contrast-Enhanced Ultrasound in the Differential Diagnosis of Benign and Malignant Superficial Cervical Lymph Nodes

作　　者：任玲 费翔[2] 张艳[2] 田晓琦 罗渝昆 REN Ling;FEI Xiang;ZHANG Yan;TIAN Xiaoqi;LUO Yukun(The Second Medical College of Lanzhou University,Lanzhou 730030,China;Department of Ultrasound,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]兰州大学第二临床医学院,甘肃兰州730030 [2]解放军总医院第一医学中心超声科,北京100853 [3]山东大学齐鲁医院超声科,山东济南250012

出　　处：《中国医学影像学杂志》2021年第10期989-992,997,共5页Chinese Journal of Medical Imaging

基　　金：解放军总医院转化项目(ZH19021)。

摘　　要：目的比较高帧率超声造影(HFR CEUS)与常规超声造影(C-CEUS)在鉴别诊断颈部浅表淋巴结(最大径≤2.0 cm)良恶性病变中的应用,探讨HFR CEUS诊断颈部浅表淋巴结的潜在应用价值。资料与方法收集40例行高频超声检查发现颈部异常淋巴结(最大径0.5~2.0 cm)的患者,均行C-CEUS及HFR CEUS检查,以病理结果为“金标准”分为良性组和恶性组,比较2种CEUS动脉期增强方向及增强均匀性的差异,采用受试者工作特征(ROC)曲线分析2种CEUS的诊断效能。结果2种CEUS评估淋巴结动脉期增强方向差异有统计学意义(良性:χ^(2)=12.711,P<0.05;恶性:χ^(2)=7.046,P<0.05),增强均匀性差异无统计学意义(P>0.05),HFR CEUS的诊断敏感度、特异度分别为85.7%、84.6%;C-CEUS的诊断敏感度、特异度分别为78.6%、65.4%。HFR CEUS与C-CEUS的ROC曲线下面积分别为0.852、0.720。结论HFR CEUS有助于准确显示颈部淋巴结动脉期的增强方向。Purpose To explore the clinical application value of high frame rate contrast-enhanced ultrasound(HFR CEUS)by comparing its application and conventional contrast-enhanced ultrasound(C-CEUS)in the differential diagnosis of benign and malignant superficial lymph nodes(maximum diameter smaller than 2.0 cm).Materials and Methods A total of 40 patients with suspected abnormal neck lymph nodes with a maximum diameter of 0.5-2.0 cm were retrospectively selected.With pathological results as the“gold standard”,patients were divided into benign group and malignant group.All patients underwent C-CEUS and HFR CEUS,and the results were recorded.The differences in the direction and uniformity of enhancement in the arterial phase of the two CEUS were compared,and the diagnostic efficacy of the two CEUS techniques was analyzed by ROC curve.Results In the benign and malignant groups,there were statistically significant differences in the direction of contrast enhancement between C-CEUS and HFR CEUS in the evaluation of lymph node arterial phase(benign group:χ^(2)=12.711,P<0.05;malignant group:χ^(2)=7.046,P<0.05);there was no significant difference in the uniformity of enhancement between the two methods(P<0.05).The diagnostic sensitivity and specificity of HFR CEUS were 85.7% and 84.6%,respectively;and those of C-CEUS were 78.6% and 65.4%,respectively.The area under ROC curve of HFR CEUS and C-CEUS were 0.852 and 0.720,respectively.Conclusion HFR CEUS can improve the indication of lymph node enhancement direction in arterial phase and enhance the confidence in the diagnosis of benign and malignant superficial cervical lymph node lesions.

关 键 词：淋巴结 超声检查 造影剂 病理学 外科 诊断 鉴别 

分 类 号：R445.1[医药卫生—影像医学与核医学] R322.25[医药卫生—诊断学]