微血管成像联合实时剪切波弹性成像在浅表淋巴结良恶性鉴别上的价值  

The Value of Superb Microvascular Imaging Combined with Ultrasound Shear Wave Elastography in the Benign and Malignant Identification of Superficial Lymph Nodes

作　　者：卢建明[1] 武雅婷 田锦[1] 常瑞姣 Lu Jianming;Wu Yating;Tian Jin;Chang Ruijiao(Department of Ultrasound,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院超声科,银川市750004

出　　处：《中国超声医学杂志》2024年第10期1157-1160,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨微血管成像联合实时剪切波弹性成像在浅表淋巴结良恶性鉴别诊断上的价值。方法选取195例患者共计216个浅表淋巴分别进行微血管成像(SMI)、超声剪切波弹性成像(SWE)检查,以穿刺活检病理为金标准,比较SMI、SWE及二者联合在浅表淋巴结良恶性鉴别诊断上的效能。结果216个淋巴结穿刺病理结果为:正常41个,反应性增生61个,结核2个,梅毒4个;恶性(含转移性)108个。单一SMI、SWE及二者联合检测诊断浅表淋巴结良恶性组间差异有统计学意义(P<0.001);单一SMI、SWE及二者联合诊断浅表淋巴结的ROC曲线下面积分别为0.757、0.755及0.845;单一SMI、SWE及二者联合鉴别浅表淋巴结性质的灵敏度分别为75.23%、62.04%、85.51%;特异度分别为75.70%、82.41%、93.75%;准确度分别为75.46%、72.22%及88.89%。结论SMI联合SWE有助于浅表淋巴结良恶性的鉴别诊断,提高诊断效能,降低误诊、漏诊率,为临床医师提供更多客观诊断依据。Objective To investigate the value of ultramicrovascular imaging combined with ultrasound shear wave elastography in the differential diagnosis of benign and malignant superficial lymph nodes.Methods A total of 216 superficial lymph nodes in 195 patients were selected for superb microvascular imaging(SMI)and ultrasound shear wave elastography(SWE)examination and the puncture biopsy pathology was used as the gold standard to compare the efficacy of SMI,SWE,and the combination of the two in the benign and malignant differential diagnosis of superficial lymph nodes.Results The pathological results of 216 lymph node puncture were as follows:41 normal lymph nodes,61 reactive hyperplasia,2 tuberculosis,4 syphilis;108 malignant(including metastatic).The difference between the benign and malignant superficial lymph nodes diagnosed by the single SMI,SWE and the combination of the two was statistically significant(P<0.001);The area under the ROC curve for diagnosing superficial lymph nodes by the single SMI,SWE and the combination of the two were 0.757,0.755 and 0.845,respectively;the sensitivities for identifying the nature of superficial lymph nodes by the single SMI,SWE and the combination of the two were 75.23%,62.04%and 85.51%;the specificities were 75.70%,82.41%and 93.75%,respectively;and the accuracies were 75.46%,72.22%and 88.89%,respectively.Conclusions SMI combined with SWE is helpful to the differential diagnosis of benign and malignant superficial lymph nodes,improves the diagnostic efficacy,reduces the rate of misdiagnosis and underdiagnosis,and provides more objective diagnostic basis for clinicians.

关 键 词：微血管成像 实时剪切波弹性成像 浅表淋巴结 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R733.1[医药卫生—诊断学]