浅表淋巴结结核病变诊断中超声弹性成像联合超声造影的应用价值分析  

Analysis of the value of ultrasound elastography combined with ultrasonography in the diagnosis of superficial lymphatic tuberculosis lesions

作　　者：钱兆轩 左卫娜 彭海军[1] 张琦[1] QIAN Zhaoxuan;ZUO Weina;PENG Haijun;ZHANG Qi(Department of Function,Hebei,Chest Hospital,Shijiazhuang 050000,China)

机构地区：[1]河北省胸科医院功能科,河北石家庄050000

出　　处：《医学影像学杂志》2024年第6期30-33,共4页Journal of Medical Imaging

基　　金：河北省医学科学研究课题计划项目(编号:20200838)。

摘　　要：目的探讨超声弹性成像(UE)联合超声造影(CEUS)、常规超声诊断浅表淋巴结结核病变价值及与病理结果的一致性。方法选取135例疑似浅表淋巴结结核病变患者均行UE、CEUS、常规超声检查。统计超声检查结果,以穿刺病理诊断结果为“金标准”,对比分析UE+CEUS、常规超声诊断浅表淋巴结结核病变的价值,并分析UE+CEUS、常规超声检查对钙化的检出率及诊断不同分型浅表淋巴结结核病变与病理结果的一致性。结果UE+CEUS诊断浅表淋巴结结核病变的敏感度、特异度、准确度分别为97.96%、91.89%、96.30%,其中敏感度、准确度均高于常规超声检查,差异有统计学意义(P<0.05);UE+CEUS对钙化的检出率(100%)高于常规超声检查(86.96%),差异有统计学意义(P<0.05);UE+CEUS诊断病变淋巴结分型与病理结果的一致性Kappa值为0.941(95%CI为0.816~1.066),符合率为95.83%,差异有统计学意义(P<0.05)。结论UE+CEUS诊断浅表淋巴结结核病变的敏感度、准确度明显高于常规超声检查,且能准确检出钙化灶,诊断浅表淋巴结结核病变分型与病理结果的一致性较高。Objective To investigate the value of ultrasound elastography(UE)combined with ultrasonography(CEUS)and conventional ultrasound in the diagnosis of superficial lymphatic tuberculosis lesions and the agreement with pathological findings.Methods 135 patients with suspected superficial lymphatic tuberculosis were selected and examined by UE,CEUS and conventional ultrasound.The results of the ultrasound examinations were counted and the value of UE+CEUS and conventional ultrasound in the diagnosis of superficial lymphatic tuberculosis was compared and analyzed,using the pathological findings of puncture as the"gold standard",as well as the detection rate of calcification by UE+CEUS and conventional ultrasound and the consistency of the diagnosis of superficial lymphatic tuberculosis of different types with the pathological findings.Results The sensitivity,specificity and accuracy of UE+CEUS in diagnosing superficial lymphatic nodule lesions were 97.96%,91.89% and 96.30%,respectively,of which the sensitivity and accuracy were higher than those of conventional ultrasound,and the difference was statistically significant(P<0.05);the detection rate of calcification by UE+CEUS(100.00%)was higher than that of conventional ultrasound(86.96%),and the difference was statistically significant(P<0.05).The Kappa value for the concordance between UE+CEUS diagnostic lesion lymph node typing and pathological findings was 0.941(95%CI 0.816-1.066),with a compliance rate of 95.83%(P<0.05).Conclusion The sensitivity and accuracy of UE+CEUS in diagnosing superficial lymphatic tuberculosis lesions were significantly higher than those of conventional ultrasound,and calcified foci could be accurately detected,and the consistency of diagnosing superficial lymphatic tuberculosis lesion sites,staging and pathological findings was higher.

关 键 词：浅表淋巴结结核病变 超声检查 超声弹性成像 

分 类 号：R551.2[医药卫生—血液循环系统疾病] R445.1[医药卫生—内科学]