彩色多普勒超声对颈部淋巴结结核的临床诊断价值分析

Analysis on clinical diagnostic value of color doppler ultrasonography in cervical lymph node tuberculosis

目的研究彩色多普勒超声对颈部淋巴结结核的临床诊断价值。方法选取2014年1月～2017年11月,于我院接受彩色多普勒超声检查的颈部肿大淋巴结患者134例为研究对象。将其按照是否为结核性淋巴结分为结核性淋巴结组65例与非结核性淋巴结组69例,分别比较两组各项彩色多普勒超声指标水平,同时比较两组血流分型情况,分析结核性淋巴结发生部位情况。结果结核性淋巴结超声特征如下:皮质向心性增宽,髓质较为偏心、变薄,直至消失。非结核性淋巴结皮质均匀性增宽、髓质回声增强或回声降低、皮髓质分界模糊。结核性淋巴结组L/S比值为(2.13±0.52),明显高于非结核性淋巴结组的(1.79±0.41),而最大血流速度为(20.67±9.18)cm/s,明显低于非结核性淋巴结组的(24.31±10.44)cm/s,组间对比差异有统计学意义(P <0.05)。结核性淋巴结组淋巴门型占比为29.23%(19/65),明显高于非结核性淋巴结组的10.14%(7/69),而混合型占比为40.00%(26/65),明显低于非结核性淋巴结组的59.42%(41/69),组间对比差异有统计学意义(P <0.05)。结核性淋巴结发生部位按照占比从高到低的顺序分别为颈中部、颈下部、锁骨上部,且颈中部发生情况显著高于其他部位,组间对比差异有统计学意义(P <0.05)。结论彩色多普勒超声应用于颈部淋巴结结核的临床诊断中效果明显,有利于早期诊断病变情况,值得临床推广应用。

Objective To study the clinical diagnostic value of color Doppler ultrasonography in cervical lymph node tuberculosis.Methods 134 patients with cervical lymph node tuberculosis who received color Doppler ultrasonography in our hospital from January 2014 to November 2017 were selected as research objects.They were divided into the tuberculouslymph node group with 65 cases and the non-tuberculouslymph node group with 69 caseswhether they were tuberculous lymph nodes or not.The levels of various color Doppler ultrasound indexes in the two groups were compared respectivelyand the blood flow classification in the two groups was also compared to analyze the location of tuberculous lymph nodes.Results The ultrasonographic features of tuberculous lymph nodes were as follows:the cortical centripetality was broadened and the medulla is more eccentric and thin,until it disappears.The cortical uniformity of non-tuberculous lymph node was broadened,the medullary echo wass enhanced or reduced,and the boundaries of the cortex and medulla are blurred.The L/S ratio of the tuberculous lymph node group was(2.13±0.52),significantly higher than that of the non-tuberculous lymph node group(1.79±0.41),but the maximum blood flow velocity was(20.67±9.18)cm/s,significantly lower than that of the non-tuberculous lymph node group(24.31±10.44)cm/s.There were statistically significant differences between the two groups(all P<0.05).The proportion of hilar type in the tuberculous lymph node group was 29.23%(19/65),significantly higher than that in the non-tuberculous lymph node group(10.14%)(7/69),but the proportion of mixed type was 40.00%(26/65),significantly lower than that of non-tuberculous lymph node group59.42%(41/69).There were statistically significant differences between the two groups(all P<0.05).Tuberculous lymph nodes were located in the middle of the neck,the lower part of the neck and the upper part of the clavicle in the order of proportion from high to low,and the occurrence of the middle part of the neck was significantly higher than that of other parts.There were statistically significant differences between the two groups(all P<0.05).Conclusion Color Doppler ultrasonography in clinical diagnosis of cervical lymph node tuberculosis has significant effect.It is helpful for early diagnosis of pathological changes and worthy of clinical application.