超声对颈部浅表淋巴结良恶性鉴别诊断的价值

Value of ultrasonography in differentiating malignant and benign superficial cervical lymph nodes

目的探讨超声鉴别诊断颈部浅表淋巴结良恶性的价值。方法 对60例颈部浅表淋巴结肿大患者,根据手术及超声引导下穿刺活检结果分为良性淋巴结组和恶性淋巴结组,分析其超声图像特点。结果 本组37例经手术病理确诊,23例经超声引导穿刺确诊。良性淋巴结组24例,恶性淋巴结组36例。75.00%(27/36)恶性淋巴结长径/短径比值(L/S)<2,75.00%(27/36)有淋巴结融合,淋巴门消失者占97.22%(35/36),血流分布呈周边型占55.56%(20/36)、混合型占19.44%(7/36),血流阻力指数(RI)为0.76±0.13,与良性淋巴结组比较差异均有统计学意义(P<0.05)。结论 超声图像特征和超声引导下穿刺活检相结合,可以明显提高浅表淋巴结良恶性的鉴别诊断能力。

Objective To observe the value of ultrasonography in differentiating malignant and benign superficial cervical lymph nodes.Methods Totally 60 patients with superficial cervical lymphadenectasis underwent high-frequency ultrasonography.According to pathologic outcomes from the surgery or fine needle biopsy guided with ultrasound,the patients were divided into two groups：Benign lymph nodes group and malignant lymph nodes group,and their ultrasonic features were analyzed.Results Twenty-four patients were in benign lymph nodes group and 36 in malignant lymph nodes group.In malignant lymph nodes group,75.00%（27/36） of L/S were 2,75.00%（27/36） of the borderlines were blurred,97.22%（35/36） hilar disappeared,peripheral blood flow distribution could be observed in 55.56%（20/36） of them,central blood flow distribution accounted for 19.44%（7/36）,and vessel resistance index（RI） were 0.76±0.13.There were statistically differences between the two groups（P0.05）.Conclusion The ability to differentially diagnosing malignant and benign superficial cervical lymph nodes can be obviously enhanced with the combination of ultrasonography and fine needle biopsy guided with ultrasound.