头颈部恶性肿瘤患者颈部肿大淋巴结的超声诊断

Ultrasonic differential diagnosis of cervical tumescent lymph nodes in patients with malignant tumor in head and neck

目的探讨头颈部恶性肿瘤患者颈部肿大淋巴结的超声诊断价值。方法回顾分析经手术证实的46例头颈部恶性肿瘤患者颈部肿大淋巴结的超声检出情况。二维及彩色多普勒超声观察患者颈部肿大淋巴结的数目、纵横比、形态、边界、内部回声、有无微小钙化及内部血流状态等。结果46例患者中甲状腺癌22例、鼻咽癌15例、恶性淋巴瘤9例。超声检查共探及颈部肿大淋巴结93枚。术后经病理诊断为肿瘤淋巴结转移者75枚,非淋巴结转移18枚。肿瘤转移淋巴结纵横比<1.5者占84.9%,内部回声不均者占75.3%,边界欠规则者占74.0%、淋巴结内可见微小钙化者占32.9%。转移性和非转移性淋巴结组间上述超声指标比较,差异均具有统计学意义(P<0.05)。转移性淋巴结血流分布较丰富,多普勒血流速度(PSV)和阻力指数(RI)也高于非转移性淋巴结(P<0.05)。结论超声是诊断头颈部恶性肿瘤颈部淋巴结转移的一种简便、有效的方法。

Objective To explore the value of ultrasonic differential diagnosis of cervical tumescent lymph nodes in patients with malignant tumor in head and neck. Methods The cervical tumescent lymph nodes in 46 patients with malignant tumor in head and neck were confirmed by surgery, then their detection information was analyzed retrospectively. The cervical lymph node number, aspect ratio, shape, border, internal echo, with or without microcalcifications and internal blood flow status were observed by two -dimensional ultrasound and color Doppler ultrasound. Results in 46 patients, there were 22 cases of thyroid carcinoma, 15 cases of nasopharyngeal carcinoma, and 9 cases of malignant lymphoma. Ninty - three cervical lymph nodes were detected by ultrasound, including 75 were metastatic confirmed by pathology, 18 were non - metastatic. The aspect ratio of lymph nodes was lower than 1.5, accounted for 84.9% , the unequal echo was found in 75.3% of lymph nodes , unequal border in 74.0% of lymph nodes, microcalcification in 32.9% of lymph nodes. There was significant differences of ultrasonic parameters between metastatic and non - metastatic lymph nodes （P 〈 0.05 ）. The blood flow distribution of metastatic lymph nodes was rich, and the Doppler blood flow velocity （ PSV ） and resistive index （RI） were higher than those of non - metastatic lymph nodes （ P 〈 0.05 ）. Conclusion Ultrasound is a convenient and effective method in diagnosis of cervical lymph node metastasis in patients with malignant tumor in head and neck.