超声造影伽马拟合时间强度曲线对颈部浅表淋巴结病变的诊断价值

Diagnostic value of ultrasound contrast and time intensity curve of gamma fitting in superficial cervical lymph nodes lesions

目的探讨超声造影伽马拟合时间强度曲线对颈部浅表淋巴结病变的诊断价值。方法收集我院拟行颈部浅表淋巴结病灶切除或穿刺活检术的患者60例,术前均行二维、彩色多普勒超声和超声造影检查,发现并记录病灶特征及参数指标。以手术病理结果为诊断金标准,分析超声造影诊断良恶(转移)性淋巴结的敏感性、特异性和准确性。结果 160例浅表淋巴结经病理诊断确定良性29例,恶性转移31例。2超声造影结果示良性淋巴结在造影后主要表现为均匀显著灌注(24/29);恶性转移淋巴结则主要表现为不均匀高灌注(22/31)或不均匀低灌注(5/31);3Q-LAB分析软件自动描记伽马拟合时间强度曲线定量分析,良性淋巴结组峰值强度(PI)、初始强度(C)、曲线上升支斜率(A)、曲线下面积(AUC)大于恶性转移淋巴结组(P<0.05),良性淋巴结组曲线上升时间(RT)、达峰时间(TTP)、平均渡越时间(m TT)、浓度减半时间(T1/2)均小于恶性转移淋巴结组(P<0.01)。超声造影诊断良恶(转移)性淋巴结的敏感性为87%,特异性为83%,准确性为85%。结论颈部浅表淋巴结造影后的灌注特征和伽马拟合时间强度曲线定量分析对浅表淋巴结疾病的定性诊断提供了有利依据。

Objective To investigate the diagnostic value of contrast ultrasound and curve of gamma fitting in superficial cervical lymph nodes diseases. Methods Sixty patients, who were scheduled for superficial cervical lymph node excision or needle biopsy in our hospital, were included as the subjects in the study. All the patients were examined by two-dimensional, color doppler ultrasound and ultrasound contrast before the operation. And the lesion features and parameters were found and recorded. The sensitivity, specificity and accuracy of using ultrasound contrast in the diagnosis of benign and malignant（metastatic） lymph nodes were analyzed on the basis of the pathological re-sults of the operation, which was the gold standard for diagnosis. Results 1Twenty-nine benign cases and 31 malignant metastatic cases among 60 of superficial lymph nodes were confirmed by pathological diagnosis. 2The result of ultrasound contrast showed that the benign lymph nodes mainly appeared evenly significant perfusion（24/29）; while malignant metastatic lymph nodes mainly appeared uneven hypertransfusion（22/31） or uneven hypoperfusion（5/31）.3The quantitative analysis of time intensity curve of gamma fitting was traced automatically by Q-LAB software. The peak intensity（PI）, basic intensity（C）, curve ascending slope（A）, and area under curve（AUC） in the benign lymph nodes group were significantly higher than those in the malignant metastatic lymph nodes group（ P〈0.05）. The rise time（RT）, time to peak（TTP）, mean transit time（m TT）, and the time of half concentration（T1/2） in the benign lymph nodes group were lower than those in the malignant metastasis lymph nodes group（ P〈0.01）. The sensitivity, specificity and accuracy of using ultrasound contrast in the diagnosis of benign and malignant（metastatic） lymph nodes were87%, 83% and 85%, respectively. Conclusion The perfusion characteristics of the superficial cervical lymph nodes after the lymphadenography and the quantitative analysis of time intensity curve of gamma fitting provide a favorable basis for the qualitative diagnosis of superficial lymph nodes diseases.