不同病理类型肺癌锁骨上转移淋巴结的超声造影特征及TIC参数分析  

Contrast-Enhanced Ultrasound Characteristics and TIC Parameters of Supraclavicular Metastatic Lymph Nodes from Different Pathologic Types of Lung Cancer

作　　者：范潇 聂芳[1] 王国娟[1] 王兰 王佩华 Fan Xiao;Nie Fang;Wang Guojuan;Wang Lan;Wang Peihua(Ultrasound Medical Center,The Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院超声医学中心,兰州市730030

出　　处：《中国超声医学杂志》2022年第4期390-394,共5页Chinese Journal of Ultrasound in Medicine

基　　金：甘肃省重点研发计划项目(No.21YF5FA122)。

摘　　要：目的探讨超声造影(CEUS)对肺癌锁骨上淋巴结转移的诊断价值,并比较分析不同病理类型肺癌锁骨上转移淋巴结的CEUS表现。方法回顾性分析289例肺癌患者共计342枚锁骨上肿大淋巴结,依据病理结果分为未转移组(124枚)、转移组(218枚),比较两组淋巴结的CEUS特征,评价CEUS对肺癌锁骨上淋巴结转移的诊断效能;依据肿瘤病理类型将转移组淋巴结分为鳞癌组(69枚)、腺癌组(97枚)、小细胞癌组(52枚),比较三组淋巴结CEUS特征及时间-强度曲线参数间的差异。结果未转移组与转移组淋巴结在CEUS增强强度、增强均匀性、灌注模式、是否有灌注缺损上差异有统计学意义(P<0.05)。CEUS诊断肺癌锁骨上淋巴结转移的准确率为90.6%、特异度为82.3%、灵敏度为95.4%。与鳞癌组、小细胞癌组相比,腺癌组淋巴结增强更均匀、更少有灌注缺损、峰值分布离散系数更小;与腺癌组、小细胞癌组相比,鳞癌组淋巴结的增强强度更低,曲线下面积、峰值强度更小;小细胞癌组淋巴结的曲线上升支斜率小于鳞癌组、腺癌组(P<0.05)。结论CEUS在诊断肺癌锁骨上淋巴结转移中有一定的应用价值,并可进一步为鉴别肿瘤病理类型提供一定的影像学依据。Objective To explore the value of contrast-enhanced ultrasound(CEUS)in diagnosis of supraclavicular lymph node metastasis of lung cancer,and to compare CEUS manifestations of supraclavicular metastatic lymph nodes from different pathologic types of lung cancer.Methods A total of 342 supraclavicular lymph nodes from 289 patients with lung cancer were retrospectively analyzed.They were divided into the non-metastatic group and the metastatic group by pathological results.Compared the CEUS features of two groups,and evaluated the diagnostic efficacy of CEUS in diagnosis of supraclavicular lymph node metastasis of lung cancer.Moreover,the lymph nodes of the metastatic group were further divided into squamous cell carcinoma group,adenocarcinoma group,and small cell carcinoma group according to the pathological type of lung cancer.And compared the CEUS features and time intensity curve(TIC)parameters among the three groups.Results There were significant differences in CEUS enhancement intensity,enhancement uniformity,perfusion pattern and perfusion defect between the non-metastasis group and metastasis group(P<0.05).The accuracy,specificity and sensitivity of CEUS in diagnosis of supraclavicular lymph node metastasis of lung cancer were 90.6%,82.3%and 95.4%respectively.Compared with the squamous cell carcinoma group and small cell carcinoma group,the adenocarcinoma group’s enhancement uniformity was more uniform,perfusion defect was less,and coefficient of variation(CV)was smaller.Compared with the adenocarcinoma group and small cell carcinoma group,the squamous cell carcinoma group’s enhancement intensity was lower,peak intensity(PI)and area under curve(AUC)were smaller.The wash-in slope(WIS)of the small cell carcinoma group was smaller than that of adenocarcinoma group and squamous cell carcinoma group.Conclusions CEUS has certain value in diagnosing supraclavicular lymph node metastasis of lung cancer,and can provide imaging evidence for differentiating the pathological types of lung cancer.

关 键 词：超声造影 锁骨上淋巴结 肺癌 病理类型 

分 类 号：R445.1[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]