彩色多普勒超声对浅表肿大淋巴结病变的鉴别诊断价值

The differential diagnosis of superficial lymphadenopathy by color Doppler sonography

目的探讨彩色多普勒超声对常见良、恶性浅表淋巴结病变的鉴别诊断价值。方法回顾性分析116例患者的139个浅表肿大淋巴结的彩色多普勒声像图,依病理及随访结果分为三组:反应性增生淋巴结组、淋巴瘤组及转移性淋巴结组。比较其长径与短径比(L/S)、淋巴门位置形态及血流分布状况,并据此三项指标建立判别函数,讨论其鉴别诊断价值。结果运用上述三项指标及判别函数能较好的区分反应性增生淋巴结与恶性淋巴结(淋巴瘤及转移性淋巴结),其正确率为88.5%,三项指标的判别能力大小依次为:淋巴门位置形态、血流分布、L/S。但仅此三项指标仍不易区分淋巴瘤与转移性淋巴结。结论超声在常见浅表肿大淋巴结良、恶性病变鉴别诊断方面有较高的应用价值。

Objective To assess the diagnostic value of color Doppler sonography in differentiating the benign lympadenopathy from the malignant. Methods The sonographies of 116 cases with 139 lymph nodes were reviewed in the study. These nodes were clarified as three categories： reactive nodes, metastatic nodes and lymphoma, according to their pathologic or clinical results. Their sonographic characteristics were compared：the long- to- short ration（US）, the echogenic of hilus, the vascular pattern within three categories, and a discriminate function according to these characteristics was established. Results The reactive nodes could be well differentiated from the malignant （metastasis and lymphoma） and the accuracy of the function was 88.5 %. The descending sequence of their discriminate capability was as following： the echogenic of hilus, the vascular pattern,and US. But it was still difficult to identify metastaic nodes from lymphoma by the three characteristics. Conclusion Color Doppler sonography plays an important role in differentiating the benigh superficial lymphadenopathy from the malignant.