浅表转移性淋巴结及淋巴瘤的超声诊断及鉴别诊断  

Ultrasound diagnosis and differential diagnosis of superficial metastatic lymph nodes and lymphoma

作　　者：冯若璇 谭小蕖[1] 钱林学[1] 赵军凤[1] 刘玉江[1] 马霞[1] 刘冬[1] 邱兰燕[1] 徐瑞芳[1] 张宏[1] FENG Ruo-xuan;TAN Xiao-qu;QIAN Lin-xue(Department of Ultrasound,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院超声科,北京100050

出　　处：《中国医学装备》2021年第12期72-77,共6页China Medical Equipment

摘　　要：目的:分析探讨浅表转移性淋巴结及淋巴瘤的声像图特点,以提高超声诊断准确率。方法:选取医院收治的136例(138枚)浅表转移性淋巴结及淋巴瘤(除甲状腺癌外)患者,依据病理结果将其分为淋巴瘤组(39例,40枚)和转移组(97例,98枚),所有患者均在放化疗前经超声诊断并采集声像图,分析其临床和声像图特点,包括是否合并临床症状和(或)体征、淋巴结大小、形状、边缘、淋巴结门回声、皮质回声、内部回声、有无钙化及血流模式。结果:淋巴瘤组出现临床症状和(或)体征、可触及肿块及发热的比例高于转移组,差异有统计学意义(χ^(2)=18.816,χ^(2)=8.166,χ^(2)=4.957;P<0.05);淋巴瘤组较转移组的淋巴结长径更大,差异有统计学意义(t=1.678,P<0.05)。两组形态不规则、淋巴结门样血流、周边血流、网格样改变及部分极低回声或条索样改变以及回声不均匀比较,差异均有统计学意义(χ^(2)=15.971,χ^(2)=8.530,χ^(2)=10.344,χ^(2)=43.488,χ^(2)=32.137;P<0.05)。在纳入的可疑超声征象中,网格样改变、部分极低回声或条索样改变较好的提示为淋巴瘤;而回声不均匀、形态不规则提示为转移性淋巴结。结论:淋巴瘤的声像图特点与转移性淋巴结存在差异,常规超声对鉴别浅表转移性淋巴结及淋巴瘤有一定临床意义。Objective:To explore the sonographic features of superficial metastatic lymph nodes and lymphoma so as to improve the diagnosis rate of ultrasound.Methods:A total of 136 patients(138 pieces)with superficial metastatic lymph nodes and lymphoma(except for those from thyroid cancer)were selected.According to the pathological results,they were divided into lymphoma group(40 pieces)and metastasis group(98 pieces).The two groups underwent ultrasonic diagnosis and their sonographic pictures were collected before the chemotherapy and radiotherapy.And the features of clinical diagnoses and ultrasound images were retrospectively analyzed,which included whether combined with clinical symptoms and(or)signs,lymph node size,shape,edge,lymph node portal echo,cortical echo,internal echo,presence or absence of calcification,and the pattern of blood flow.Results:The ratios of occurring clinical symptoms and(or)signs,touchable tumor and fever of lymphoma group were significantly higher than those of metastasis group(χ^(2)=18.816,χ^(2)=8.166,χ^(2)=4.957,P<0.05).Compared with metastasis group,the long diameter of lymph nodes of lymphoma group was larger(t=1.678,P<0.05).And the differences of irregular morphology,and hilar flow,peripheral flow,reticular change,a part of extremely hypoechoic or cord-like changes,and heterogeneous echo between lymphoma group and metastasis group were significant(χ^(2)=15.971,χ^(2)=8.530,χ^(2)=10.344,χ^(2)=43.488,χ^(2)=32.137,P<0.05).Reticular changes,extremely hypoechoic or cord-like changes indicated lymphoma.Heterogeneous echo and irregular shape indicated metastatic lymph nodes.In the included suspicious ultrasound sings,the reticular change,a part of extremely hypoechoic or cord-like change could better hint lymphoma,and heterogeneous echo and irregular morphology could better hint metastatic lymph node.Conclusion:There are differences in sonographic characteristics between lymphoma and metastatic lymph nodes.Routine ultrasound plays a certain of clinical significance in distinguishing super

关 键 词：淋巴瘤 转移性淋巴结 超声检查 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]