颈部肿大淋巴结内血流灌注的CEUS参数成像

Parametric imaging of CEUS for blood perfusion in cervical lymphadenopathy

目的探讨CEUS参数成像在颈部淋巴结不同病变中的诊断价值。方法 111例诊断为颈部肿大淋巴结的患者均接受CEUS参数成像。根据病理结果将患者分为反应性增生组、结核组、转移组及淋巴瘤组,比较4组灌注时相(动脉相灌注、动脉相及实质相灌注)与灌注均匀度(均匀灌注、不均匀灌注)。根据病理结果将反应性增生组与结核组合并为良性组、转移组与淋巴瘤组合并为恶性组;以动脉相灌注为良性,动脉相及实质相灌注为恶性,比较2组参数成像与病理结果的一致性。结果 4组灌注时相与灌注均匀度差异均有统计学意义(P均<0.05),其中反应性增生组与转移组、淋巴瘤组,结核组与转移组灌注时相比较差异均有统计学意义(P均<0.008);反应性增生组与结核组、转移瘤组,淋巴瘤组与结核组、转移组灌注均匀度比较差异均有统计学意义(P均<0.008)。良性组与恶性组CEUS参数成像的灌注时相比较差异有统计学意义(P<0.05),灌注均匀度比较差异无统计学意义(P>0.05)。CEUS参数成像诊断的良、恶性淋巴结与病理结果的一致性尚可。结论 CEUS参数成像可为常规超声难以判定性质的淋巴结诊断提供有价值的诊断信息。

Objective To explore the diagnostic value of parametric imaging of CEUS in different cervical lymphatic diseases. Methods One hundred eleven patients diagnosed with cervical lymphadenopathy were included. All of the patients underwent parametric imaging of CEUS. According to the pathological results, all patients were divided into reactive hyperplasia group, tuberculosis group, metastasis group and lymphoma group. The features of perfusion phases （perfusion during the artery phase, or perfusion during the artery and parenchymal phase） and perfusion uniformity （homogeneous perfusion or heterogeneous perfusion） were compared among four groups. According to the pathological results, the reactive hyperplasia group and the tuberculosis group were merged into a benign group, and the metastasis group and the lymphoma group were merged into a malignant group. Then, the artery perfusion phase was regarded as benign, and the artery and parenchymal perfusion phase was regarded as malignant. The consistency between parametric imaging of CEUS and the pathological results was compared in two groups. Results The difference of perfusion phase and perfusion uniformity within the four groups had a statistical significance （all P〈0.05）. The differences of perfusion phase between the reactive hyperplasia group and the metastasis group, the reactive hyperplasia group and the lymphoma group, the tuberculosis group and the metastasis group were statistical significant respectively （all P〈0.008）. The differences of perfusion uniformity between the reactive hyperplasia group and the tuberculosis group, the reactive hyperplasia group and the lymphoma group, the lymphoma group and the tuberculosis group, the lymphoma group and the metastasis group were statistical significant respectively （all P〈0.008）. The perfusion phase between the benign group and the malignant group had a statistical significance （P〈0.005）, but the perfusion uniformity had no statistical significance in two groups. The consistency was good between the parametric imaging and the pathological results. Conclusion The parametric imaging of CEUS can offer valuable diagnostic information for the cervical lymph nodes underdetermined by conventional ultrasound.