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中国癌症防治杂志

中国癌症防治杂志 ›› 2013, Vol. 5 ›› Issue (2): 145-148.doi: 10.3969/j.issn.1674-5671.2013.02.15

• 临床研究 • 上一篇    下一篇

超声弹性成像对颈部恶性淋巴结鉴别诊断的价值

  

  1. 广西医科大学研究生学院；广西医科大学附属肿瘤医院物理诊断中心
  • 出版日期:2013-06-25 发布日期:2013-06-27
  • 通讯作者: 李 航 E-mail:jiayouhui21@163.com
  • 基金资助:

    广西2011年研究生教育创新计划资助项目（2011105981002M181）

Diagnostic value of ultrasound elastography for detecting malignant cervical lymph nodes

  • Online:2013-06-25 Published:2013-06-27

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摘要： 目的 探讨超声弹性成像（ultrasound elastography，UE）对颈部恶性淋巴结鉴别诊断的价值。方法 对96 例患者的 96 个肿大淋巴结行二维超声（2DUS）、彩色多普勒血流成像（CDFI）及UE检查，其中UE采用弹性评分法进行评价。以超声引导下穿刺活检的病理检查结果为标准，比较常规超声与UE对颈部良、恶性淋巴结鉴别诊断的价值。结果 ①常规超声诊断颈部恶性淋巴结的敏感度、特异度、准确率、阳性预测值及阴性预测值分别为76.6%、81.3%、78.1%、89.1%及63.4%；UE诊断颈部恶性淋巴结的敏感度、特异度、准确率、阳性预测值及阴性预测值分别为90.6%、81.3%、87.5%、90.6%及81.3%。②UE诊断颈部恶性淋巴结的准确率高于常规超声，差异有统计学意义（X2=13.304，P＜0.001）；常规超声、UE与病理检查结果的吻合系数分别为0.540（P＜0.001）、0.719（P＜0.001），UE与病理检查结果的吻合度高于常规超声。结论 超声弹性成像技术对颈部恶性淋巴结的鉴别诊断具有一定的应用价值。

关键词: 弹性成像, 超声检查, 淋巴结, 鉴别诊断

Abstract: Objective To assess the diagnostic value of ultrasound elastography（UE） for detecting malignant cervical lymph nodes. Methods A total of 96 patients with cervical lymph nodes were analyzed by UE and by conventional ultrasonography（US） involving two-dimensional ultrasonography and color Doppler flow imaging. An elastic method was used to evaluate the diagnostic value of UE. All malignant lymph nodes were confirmed by pathology，and the diagnostic performance of the two methods was compared. Results The sensitivity，specificity，accuracy，and positive and negative predictive values of US in diagnosing malignant cervical lymph nodes were，respectively，76.6%，81.3%，78.1%，89.1% and 63.4%.The corresponding values for UE were 90.6%，81.3%，87.5%，90.6% and 81.3%.UE showed higher accuracy than US for diagnosing malignant cervical lymph nodes.The diagnostic agreement rate of UE with surgical pathology was 0.540（P＜0.001），compared to 0.719（P＜0.001） for US.UE showed higher diagnostic consistency than US. Conclusion UE may be useful for diagnosing malignant cervical lymph nodes.

Key words: Elastography, Ultrasonography, Lymph node, Differential diagnosis