彩色多普勒超声在良恶性颈部肿大淋巴结鉴别诊断中的价值

Valuation of Color Doppler Ultrasonography in the diagnosis of superficial cervical lymph nodes

目的:探讨彩色多普勒超声在良恶性颈部肿大淋巴结鉴别诊断中的价值。方法:对70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病理结果分为良性淋巴结肿大组和恶性淋巴结肿大组,分析其超声图像特点。结果:(1)良性淋巴结肿大组25例(包括反应性淋巴结15例,结核性淋巴结10例),恶性淋巴结肿大组45例(包括转移性淋巴结38例,淋巴瘤7例)。(2)恶性淋巴结肿大组淋巴结长径/短径比值(L/S)>2者占88.9%,淋巴结边缘模糊者占57.8%,淋巴门消失者占91.1%,与良性淋巴结肿大组相比(分别为20.0%、16.0%、16.0%)差异均有统计学意义(P<0.05)。(3)良性淋巴结肿大组淋巴门型、中央型、边缘型、混合型、无血流型5种血流分布类型的比例分别为52.0%、20.0%、4.0%、20.0%、4.0%,恶性淋巴结肿大组分别为22.2%、33.3%、24.4%、13.3%、6.7%,差异均有统计学意义(P<0.05)。结论:彩色多普勒超声检查有助于浅表淋巴结良、恶性的鉴别诊断。

To evaluate the value of color dopper ultrasonography in differentiating ma- lignant and benign superficial cervical lymph nodes. Methods：A total of 70 patients with superficial cervical nodes underwent high frequency ultrasonography. According to pathologic results 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. Twentyfive nodes were ascribed as benign lymph nodes group, including reactive lymphadenitis （n〈 15）, tuberculosis （n=10）, and 45 nodes were in malignant lymph nodes group, including lymphoma （n =7） and metastasis （n 〈38） . The vascular patterns of hilar type, central type, peripheral type, mixed type an no vascular type were assessed. Results.. Of malignant lvmoh nodes roun. 88.9%（ 40/ zt.5hnwpr] l/ q c 2, 57.8% showed vague margin, 91.1%（41/45） showed absence of hilar, comparing with the corresponding 20.0%, 16.0%, and 16.0% of the benign lymph nodes group, there was significant differences （P〈0. 05）. Central type, peripheral type , mixed type an no vascular type blood flow distribution could be observed in 52.0%.20.0% .4.0%.20.0% .4.0% were of the benign lymph nodes group, while the corresponding data was 22.2%.33.3%.24. 4%.13.3%,6. 7% of the malignant lymph nodes group （P〈0. 05）. Oonelusions：Color doppler flow imaging can be helpful to differentiate malignant and benign superficial cervical lymph nodes.