超声鉴别良恶性淋巴结价值探讨  

Role of ultrasonography in differentiating benign lymph nodes from malignat ones

作　　者：李飞[1] 张益民[1] 李林[1] 刘瑞芳[1] 何辉[1] 

机构地区：[1]解放军254医院,天津300142

出　　处：《华北国防医药》2003年第4期235-237,F003,共4页Medical Journal of Beijing Military Region

摘　　要：目的　分析探讨多普勒超声鉴别良、恶性淋巴结的价值。方法　选择 13 2例淋巴结增大病例 ,按病理或抗感染治疗结果分为淋巴结炎 86例 (组 1)、淋巴结结核 14例 (组 2 )、恶性淋巴瘤 10例 (组 3 )、转移性淋巴结 2 2例 (组 4) ,用高频探头及彩色多普勒 (CDFI)对其进行图像分析和数据测定。结果　组 1增大淋巴结周围多可见毛玻璃样炎性反应区 ,动脉血峰值流速 (Vp)为 ( 2 2 75± 8 0 0 )cm/s ,阻力指数 (RI)为 0 62± 0 0 3 ;组 2早期淋巴结周围也可见炎性反应区 ,后期有淋巴结融合、坏死液化及钙化 ,Vp为 ( 19 42± 13 2 2 )cm/s ,RI为 0 72± 0 0 9;组 3大多淋巴结内可见丰富的分支状或紊乱血流 ,部分有“穿结征”或动静脉分流 ,Vp为 ( 2 6 69± 2 0 3 5 )cm/s ,RI为 0 78± 0 2 3 ;组 4多有恶性肿瘤病史或可找到原发病灶 ,淋巴结内也可见动静脉分流现象 ,Vp为 ( 5 5 5 4± 41 87)cm/s ,RI为 0 81± 0 13。结论　①异常形态淋巴结 +“穿结征”或动静脉分流其中一项可初步判定为恶性。②异常形态淋巴结Objective To evaluate retrospectively the value of Doppler ultrasound in distinguishing lymph nodes between benign and malignant.Methods 132 cases of lymphadenovarix confirmed by histopathology or antibiotic treatment were divided into 4 groups, lymphadenitis group (group 1, n =86), lymphaden tuberculosis group (group 2, n =14), malignant lymphoma group (group 3, n =10),metastatic lymph nodes group (group 4, n =22). Color Doppler ultrasonography was applied to each of the subjects.Results In group 1,inflammation area like ground grass was noted around the enlarged lymph nodes,the peak velocity (Vp) was (22 75±8 00)cm/s and the resistant index (RI) was 0 62±0 03. In group 2,there was inflammation area around lymph nodes in early stage and liquefied、calcified and fused lymph nodes were found in late period (Vp=19 42±13 22cm/s,RI= 0 72±0 09). In group 3,plentiful branch or turbulent bloodstream were present in most lymph nodes; the vessel crossed node sign and art vein shunt could be found in some of the lymph nodes of this group (Vp = 26 09±20 35cm/s,RI= 0 78±0 23). In group 4, history of malignant tumor could be consulted or primary malignant tumor could be detected, also with presence of art vein shunt in some patients (Vp= 55 54±41 87cm/s,RI = 0 81±0 13).Conclusions ① It could be concluded that the abnormal lymph nodes with crossed node sign or art vein shunt were of malignancy. ② Malignancy could not be ruled out if abnormal lymph nodes with high Vp or high RI were found.

关 键 词：超声诊断 鉴别诊断 良恶性淋巴结 淋巴结炎 淋巴结结核 恶性淋巴瘤 

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]