超声弹性成像与常规超声对浅表淋巴结良恶性诊断鉴别价值比较

Comparison of the Value of Ultrasonic Elastography and Conventional Ultrasound in Differential Diagnosis of Benign and Malignant Superficial Lymph Nodes

目的:比较超声弹性成像(UE)与常规超声对浅表淋巴结良恶性诊断鉴别价值。方法:90例(104个淋巴结)接受常规超声、UE检查的浅表淋巴结肿大患者入选,按病理结果分为良性组、恶性组,记录其影像参数及其诊断鉴别价值。结果:恶性组长径、长短径比值、RI、弹性图分级高于良性组,两组血管模式分型也有统计学差异(P<0.05);UE(弹性分级)诊断恶性浅表淋巴结的灵敏度、特异度、准确度、Kappa值、曲线下面积(AUC)高于常规超声(长短径比值、RI),尤其是UE诊断的灵敏度、特异度、准确度明显高于长短径比值,而灵敏度、准确度也高于RI(P<0.05)。结论:UE与常规超声对浅表淋巴结良恶性均有一定诊断鉴别价值,尤其是UE弹性分级诊断价值较高。

Objective: To compare the value of ultrasound elastography(UE) and conventional ultrasound in the differential diagnosis of benign and malignant superficial lymph nodes. Methods: 90 patients(104 lymph nodes) with superficial lymphadenopathy who underwent conventional ultrasound and UE examination were divided into benign group and malignant group according to the pathological results. The imaging parameters and their diagnostic value were recorded. Results: The long diameter, ratio of long-short diameter, RI and elastography classification in malignant group were higher than those in the benign group. There also was a difference in vascular pattern classification between the two groups(P<0.05). The sensitivity, specificity, accuracy, Kappa value and area under the curve(AUC) of UE(elastic classification) for diagnosis of malignant superficial lymph node were higher than conventional ultrasound(the ratio of long-short diameter, RI). The sensitivity, specificity and accuracy of UE diagnosis were significantly higher than the ratio of long-short diameter. Besides, the sensitivity and accuracy were higher than RI(P<0.05). Conclusion: Both UE and conventional ultrasound are of certain diagnostic value for the benign and malignant superficial lymph nodes. The diagnostic value of UE elastic classification is relatively higher.