颈部无痛性肿大淋巴结高频超声声像图特点

Retrospective Analysis on the Ultrasound Features of Painless Neck Lymph Node Enlargement

目的分析经病理证实的颈部无痛性肿大淋巴结的声像图特点,比较良、恶性疾病中异常淋巴结的声像图特征,为临床医师的鉴别提供可靠的诊断依据。方法将2007年7月-2009年12月以颈部无痛性肿大淋巴结就医、并经病理证实的良、恶性疾病的97例患者作为研究对象,其中男56例,女41例;共检出淋巴结365个,依据病理诊断结果将研究对象分为良性组(98个)和恶性组(267个)。结果①大多数良性淋巴结:L/S>2,形态接近椭圆形、门部回声规则无移位、皮质较薄、髓质形态规则,居中;大多数恶性淋巴结短径相对增大,L/S≤2,形态趋于类圆形,包膜不完整,门部大多数偏离中心,皮质不均匀增厚,髓质变形移位或消失。②良性淋巴结多表现为无血流型或门部规则血流型;恶性淋巴结多表现为周边血流或混合血流型。③大多数良性淋巴结血流阻力指数偏低,RI<0.60;大多数恶性淋巴结血流阻力指数偏高,RI>0.70。结论高频超声在颈部无痛性淋巴结肿大的良恶性鉴别中能够提供重要的诊断信息。

Objective To provide reliable diagnostic basis for clinicians to distinguish between malignant and benign painless neck lymph node enlargement, by analyzing the ultrasound findings of the disease identified by pathological examination, comparing sonographic features of benign and malignant abnormal lymph nodes, and obtaining valuable sonographic diagnosis information. Methods Ninety-seven patients including 56 men and 41 women diagnosed to have painless neck lymph node enlargement proved to be benign or malignant with pathological method were selected as our subjects. They were treated in No.3 Hospital of Tangshan from July 2007 to December 2009. We detected 365 cervical lymph nodes and divided them into two groups according to pathological examination： 98 benign lymph nodes and 267 malignant. Results There were significant differences （P 〈 0.05） between the two groups in the shape of cervical lymph nodes, the ratio of long/short axis （L/S）, types of echo and hilus of lymph node. There was no significant difference （P 〉 0.05） in the long axis of cervical lymph nodes. The majority benign lymph nodes had significant hilar blood flow or had no blood flow. The majority malignant cervical lymph nodes had peripheral blood flow or mixed blood flow. There was significant difference （P 〈 0.05） in the blood flow type. There was no significant difference （P 〉 0.05） in PSV and EDV between the two groups. The RI in the benign group was 0.59 ＋ 0.12 and it was 0.71 ~： 0.11 in the malignant group, and the difference was significant （P 〈 0.05）. The vascular resistance of the majority of malignant cervical lymph nodes was higher than the benign ones. Conclusions High frequency color doppler ultrasonography is of important value in the diagnosis and differential diagnosis of cervical lymph nodes diseases. It can be regarded as one method of evaluating cervical lymph nodes.