应变弹性成像与声触诊组织成像定量技术鉴别诊断颈部良、恶性淋巴结  

Strain elastography and virtual touch tissue imaging quantification technique for differential diagnosis of benign and malignant cervical lymph nodes

作　　者：张俊鹏 夏燕飞 韩雪 种静 史琳 ZHANG Junpeng;XIA Yanfei;HAN Xue;CHONG Jing;SHI Lin(Department of Medical Ultrasound,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Ultrasound,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]山东第一医科大学附属省立医院超声医学科,山东济南250021 [2]青岛大学附属医院超声科,山东青岛266003

出　　处：《中国医学影像技术》2022年第1期137-140,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察应变弹性成像(SE)与声触诊组织成像定量(VTIQ)技术鉴别诊断颈部良、恶性淋巴结的价值。方法纳入106例接受颈部超声及颈部淋巴结组织病理学检查患者、共123个颈部异常淋巴结,根据病理结果将其分为良性组(n=34)和恶性组(n=89)。采用SE检测异常淋巴结所占面积(AREA%),以VTIQ技术检测淋巴结剪切波速度(SWV),比较2组淋巴结超声特征的差异;以病理结果作为金标准,观察SE与VTIQ技术鉴别诊断良、恶性淋巴结的效能。结果恶性组淋巴结门消失、纵横比(L/S)<2、血流阻力指数(RI)>0.7、AREA%>45.23%及SWV>3.05 m/s占比均大于良性组(P均<0.05)。以AREA%=45.23%为最佳截断值,鉴别诊断良、恶性淋巴结的敏感度为84.27%,特异度为70.59%,曲线下面积(AUC)为0.74;以SWV=3.05 m/s为最佳截断值,敏感度为88.76%,特异度为73.53%,AUC为0.84,显著大于AREA%的AUC(Z=2.83,P<0.01)。SE鉴别诊断良、恶性淋巴结的敏感度和特异度分别为76.13%和68.00%,VTIQ技术的诊断敏感度和特异度分别为84.55%和73.53%,与SE差异均无统计学意义(χ^(2)=0.27,P=0.60;χ^(2)=0.25,P=0.62)。结论SE及VTIQ技术均可定量评估颈部淋巴结硬度以鉴别其良恶性;VTIQ的诊断效能较高,SWV大于3.05 m/s提示为恶性淋巴结。Objective To observe the value of strain elastography(SE)and virtual touch tissue imaging quantification(VTIQ)technique for differential diagnosis of benign and malignant cervical lymph nodes.Methods Totally 123 abnormal cervical lymph nodes in 106 patients who underwent neck ultrasonography and cervical lymph node histopathology were enrolled.The patients were divided into benign group(n=34)and malignant group(n=89)according to pathological results.The area proportion of abnormal lymph nodes(AREA%)was detected with SE,and the shear wave velocity(SWV)was measured with VTIQ.The ultrasonic characteristics of cervical lymph nodes were compared between groups.Taken pathological results as gold standards,the efficacy of SE and VTIQ for differential diagnosis of benign and malignant cervical lymph nodes was observed.Results The proportion of lymph node hilar disappearance,long diameter/short diameter(L/S)<2,resistance index(RI)>0.7,AREA%>45.23%and SWV>3.05 m/s in malignant group were significantly higher than those in benign group(all P<0.05).Taken AREA%=45.23%as the best cutoff value,the sensitivity and specificity for differential diagnosing benign and malignant lymph nodes was 84.27%and 70.59%,respectively,and the area under the curve(AUC)was 0.74.Taken SWV=3.05 m/s as the best cutoff value,the sensitivity was 88.76%,the specificity was 73.53%,and the AUC was 0.84,which was significantly higher than that of AREA%(Z=2.83,P<0.01).The sensitivity and specificity of SE for differential diagnosis of benign and malignant cervical lymph nodes was 76.13%and 68.00%,respectively,and of VTIQ was 84.55%and 73.53%,respectively.No significant difference of sensitivity and specificity was found between SE and VTIQ(χ^(2)=0.27,P=0.60;χ^(2)=0.25,P=0.62).Conclusion Both SE and VTIQ could quantitatively evaluate the hardness of cervical lymph nodes for differential diagnosis of benign and malignant lymph nodes.The diagnostic value of VTIQ was higher,and SWV>3.05 m/s indicated malignant lymph nodes.

关 键 词：颈部 淋巴结 超声检查 弹性成像技术 

分 类 号：R733.4[医药卫生—肿瘤] R445.1[医药卫生—临床医学]