常规超声联合超声造影对颈部淋巴结结核与淋巴瘤鉴别诊断具有较高价值  

Conventional ultrasound combined with contrast-enhanced ultrasound has high value in the differential diagnosis of cervical tuberculous lymphadenitis and lymphoma

作　　者：栗春莉 李亚洲[2] 宋雨[2] 许费昀[3] 王新方[2] 张平洋[1] LI Chunli;LI Yazhou;SONG Yu;XU Feiyun;WANG Xinfang;ZHANG Pingyang(Department of Cardiovascular Ultrasound,Nanjing First Hospital,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing 210006,China;Department of Ultrasound,Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affilicated with Nanjing University of Chinese Medicine,Nanjing 210014,China;Department of Sore and Ulcer,Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affilicated with Nanjing University of Chinese Medicine,Nanjing 210014,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)心血管超声科,江苏南京210006 [2]南京中医药大学附属南京市中西医结合医院超声科,江苏南京210014 [3]南京中医药大学附属南京市中西医结合医院瘰疬科,江苏南京210014

出　　处：《分子影像学杂志》2025年第2期167-172,共6页Journal of Molecular Imaging

基　　金：江苏省中医药科技发展计划项目(ZD202228)。

摘　　要：目的探讨常规超声及超声造影在颈部淋巴结结核与淋巴瘤鉴别诊断中的价值。方法回顾性分析2020年1月~2022年12月于南京市中西医结合医院经病理证实的50例颈部淋巴结结核和31例淋巴瘤患者的常规超声和超声造影表现,比较两组患者常规超声及超声造影的声像特征,探讨各指标在两种鉴别诊断中的价值,并评估两种检查方法的诊断效能。结果常规超声发现结核组淋巴结最大长径、短径较淋巴瘤组小,内部囊性回声及边缘型或无血流的淋巴结占比多,存在条状或网格状回声、门型或混合型血流少于淋巴瘤组,差异有统计学意义(P<0.05)。超声造影显示结核组多表现为向心性、不均匀增强、有无增强区,淋巴瘤组多表现为非向心性、均匀增强、不伴无增强区,差异有统计学意义(P<0.05)。超声造影及二者联合诊断淋巴结结核的敏感度、特异度及准确性分别为90.0%、80.6%、86.4%,94.0%、87.1%、91.4%,均高于常规超声诊断的80.0%、71.0%、76.5%。结论颈部淋巴结结核和淋巴瘤患者基于常规超声及超声造影的声像特点有显著的异同性,两者联合应用具有更高的诊断和鉴别诊断价值。Objective To assess the diagnostic efficacy of conventional ultrasound and contrast-enhanced ultrasound in distinguishing between cervical tuberculous lymphadenitis and lymphoma.Methods A retrospective analysis was performed on the imaging characteristics of 50 confirmed cases of cervical tuberculous lymphadenitis and 31 cases of lymphoma,utilizing both imaging techniques at Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affilicated with Nanjing University of Chinese Medicine from January 2020 to December 2022.The diagnostic value of various indicators for distinguishing between the two conditions and the diagnostic performance of the two imaging modalities were analyzed.Results The results indicated that conventional ultrasound detected smaller maximum long and short diameter in lymph nodes of the tuberculosis group compared to the lymphoma group,with a prevalence of cystic echoes and peripheral blood flow.Internal linear or reticular echoes and mixed blood flow were less common in lymph nodes in the tuberculosis group compared to the lymphoma group,with statistically significant differences(P<0.05).Contrast-enhanced ultrasound revealed that lymph nodes in the tuberculosis group demonstrated centripetal,heterogeneous enhancement,with areas of nonenhancement,while those in the lymphoma group exhibited non-centripetal,homogeneous enhancement,without areas of non-enhancement,with statistically significant differences(P<0.05).The sensitivity,specificity,and accuracy of contrastenhanced ultrasound and the two imaging modalities combined in diagnosing tuberculosis were 90.0%、80.6%、86.4%,94.0%、87.1%、91.4%,respectively,which were higher than those of conventional ultrasound at 80.0%,71.0%and 76.5%.Conclusion The sonographic characteristics of patients with cervical tuberculous lymphadenitis and lymphoma show significant similarities and differences based on conventional ultrasound and contrast-enhanced ultrasound.The combined application of both has higher diagnostic and differential diagno

关 键 词：常规超声 超声造影 颈部淋巴结结核 淋巴瘤 

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]