气道内超声弹性成像鉴别肺癌患者肺门纵隔淋巴结良恶性的临床价值  

Clinical value of endobronchial ultrasound elastography in the differential diagnosis of benign and malignant hilar and mediastinal lymph nodes in patients with lung cancer

作　　者：杨芳[1] 姜川 廖江荣[1] YANG Fang;JIANG Chuan;LIAO Jiangrong(Department of Respiratory,Guizhou Aerospace Hospital,Guizhou 563000,China)

机构地区：[1]贵州航天医院呼吸科,贵州省遵义市563000

出　　处：《临床超声医学杂志》2024年第9期741-745,共5页Journal of Clinical Ultrasound in Medicine

基　　金：遵市科合HZ字(2022)178号;遵市科合HZ字(2023)422号。

摘　　要：目的探讨气道内超声弹性成像鉴别诊断肺癌患者肺门纵隔淋巴结良恶性的临床应用价值。方法选取于我院就诊的疑似肺癌患者87例(共147个淋巴结),经超声引导下支气管针吸活检证实良性56个,恶性91个。应用二维超声观察淋巴结形态、最大径、回声类型、内部回声分布及边缘是否清晰;气道内超声弹性成像获取淋巴结弹性评分及应变率比值,比较良恶性淋巴结二维超声和气道内超声弹性成像检查结果的差异。绘制受试者工作特征(ROC)曲线分析二维超声图像特征和定量参数,以及气道内超声弹性成像参数鉴别肺癌患者肺门纵隔淋巴结良恶性的诊断效能。结果二维超声检查显示,良恶性淋巴结最大径、形态回声类型、内部回声分布及边缘是否清晰比较差异均有统计学意义(均P<0.05)。气道内超声弹性成像检查显示,良恶性淋巴结弹性评分分别为(1.85±0.97)分和(3.36±0.91)分,应变率比值分别为20.62±17.12和87.67±49.17,差异均有统计学意义(均P<0.001)。ROC曲线分析显示,弹性评分和应变率比值鉴别肺癌患者肺门纵隔淋巴结良恶性的曲线下面积(AUC)分别为0.854和0.931,二者比较差异有统计学意义(P<0.05),且均高于二维超声图像特征和定量参数的AUC,差异均有统计学意义(均P<0.05)。结论气道内超声弹性成像可有效鉴别肺癌患者肺门纵隔淋巴结良恶性,具有较好的临床应用价值。Objective To investigate the clinical application value of endobronchial ultrasound elastography in the differential diagnosis of benign and malignant hilar and mediastinal lymph nodes in patients with lung cancer.Methods A total of 87 patients with suspected lung cancer from our hospital were selected.And a total of 147 lymph nodes were examined by ultrasound-guided transbronchial needle aspiration,which confirmed 56 benign and 91 malignant lymph nodes.The shape,maximum diameter,echo type,internal echo distribution,and edge clarity of lymph nodes were observed by two-dimensional ultrasound,while the ultrasound elasticity score and strain rate ratio were observed by endobronchial ultrasound elastography.The differences of the results of two-dimensional ultrasound and endobronchial ultrasound elastography between benign and malignant lymph nodes were compared.Receiver operating characteristics(ROC)curve was drawn to analyze the diagnostic efficacy of two-dimensional sonographic features,quantitative parameters,and endobronchial ultrasound elastographic parameters in the differential diagnosis of benign and malignant hilar and mediastinal lymph nodes in patients with lung cancer.Results Two-dimensional ultrasound showed that there were significant differences in maximum diameter,shape,echo type,internal echo distribution,and margin clarity between benign and malignant lymph nodes(all P<0.05).Endobronchial ultrasound elastography showed thatthe elasticity score ofbenign and malignantlymph nodeswere(1.85±0.97)pointsand(3.36±0.91)points,respectively,and the strain ratios were 20.62±17.12 and 87.67±49.17,respectively.The difference were statistically significant(both P<0.001).ROC curve analysis showed that the areas under the curve(AUC)of elasticity score and strain ratio in differentiating benign and malignant hilar and mediastinal lymph nodes in patients with lung cancer were 0.854 and 0.931,respectively.The difference was statistically significant(P<0.05),which were higher than AUC of two-dimensional sonographic

关 键 词：超声检查 气道内 弹性成像 肺癌 纵隔淋巴结 良恶性 

分 类 号：R445.1[医药卫生—影像医学与核医学]