良恶性浅表淋巴结肿大的超声鉴别诊断

Ultrasound differential diagnosis of benign from malignant superficial lymphadenopathy

目的 探讨高频超声对浅表淋巴结(LN)肿大良、恶性鉴别诊断价值。方法 以高频超声对浅表肿大LN进行多切面扫查,测量其最大长径(L)和最大横径(S),观察LN形态、边界、皮质及LN门回声。结果 67例患者浅表肿大LN共89个,其中良性肿大31个,恶性58个。大部分良性肿大LN保持椭圆形状,边界清楚,L/S≥2,LN皮质变薄,LN门回声保持,而恶性肿大LN多为圆形或不规则形,大部分边界清楚,L/S<2,LN皮质多呈偏心性增厚,多数无LN门回声。两组LN形态、L/S值、皮质及LN门回声差异有显著性,而边界回声差异无显著性。结论高频超声有利于浅表肿大LN性质的鉴别诊断。

To evaluate the value of ultrasound differentiation between benign and malignant superficial lymphadenopathy. Methods Enlarged superficieal lymph nodes were detected in more than one sections by using high - frequency ultrasound probe. The Maximum longitudinal (L)and short(S) diameter of the nodes were measured. The shape, margin, cortex and hilns of the nodes were also observed. Results 89 enlarged superficial lymph nodes including 31 bening and 58 malignant were observed in 67 patients. Ellipse shape, clear margin, L/S≥2, thin cortex and hyperechoic bilus were often seen in most benign nodes, while most malignant nodes showed round or irregular shape, L/S < 2, eccentric cortical widening, and also clear margin. Hilar echoes were not seen in most malignant nodes. Significant differences were observed between benign and malignant nodes in terms of nodal shape, L/S ratio, cortical and hilar echoes excluding marginal echoes Conclusion High - frequency ultrasonography is valuable in the differentiation of benign from malignant superficial lymphadenopathy.