淋巴结硅胶性肉芽肿超声特征及其诊断效能

Ultrasonic characteristics of silicone granulomas of lymph nodes and diagnostic efficiency

目的观察淋巴结硅胶性肉芽肿(SGL)的超声特征,评价其诊断效能。方法回顾性分析病理证实的15例(24枚)SGL及25例(25枚)腋窝淋巴结反应性增生(HL)的超声声像图特点,对比观察其超声特征,分析超声对SGL的诊断效能。结果SGL与HL病灶横径、边界、淋巴门、内部回声、后方回声、“暴风雪”征(前界清晰、后缘模糊的高回声团)、血流分级及血流模式差异均有统计学意义(P均<0.05),长径及形态差异无统计学意义(P均>0.05)。术前超声发现21枚淋巴结内出现“暴风雪”征,均提示SGL,并与术后病理一致。以术后病理为“金标准”,根据术前超声声像图出现“暴风雪”征诊断SGL的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为87.50%(21/24)、100%(25/25)、100%(21/21)、89.29%(25/28)及93.88%(46/49)。结论“暴风雪”征是SGL特征性超声表现,有助于诊断SGL。

Objective To observe the ultrasonic characteristics of silicone granulomas of lymph nodes(SGL),and to analyze the diagnostic efficiency of these characteristics.Methods Ultrasonic characteristics of 15 patients with 24 pathologically confirmed SGL lesions and 25 patients with 25 hyperplastic lymph(HL)nodes were retrospectively analyzed.The ultrasonic characteristics were compared between SGL and HL,and the diagnostic efficiency of ultrasonic signs for SGL was analyzed.Results The transverse diameter,boundary,status of lymphatic hilum,posterior acoustic effect,internal echogenicity,"blizzard"appearance(a hyperechoic mass with distinct anterior boundary and blurring posterior boundary),degree of vascularity and vascularity pattern were all significantly different(all P<0.05),while the morphology and longitudinal diameter showed no significant difference between SGL and HL(both P>0.05).Totally 21 lymph nodes with"blizzard"appearance on ultrasonograms were regarded as SGL before surgical operation,and then confirmed SGL with histopathologic examinations.Taken postoperative histopathology as standard,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of"blizzard"appearance for diagnosing SGL was 87.50%(21/24),100%(25/25),100%(21/21),89.29%(25/28)and 93.88%(46/49),respectively.Conclusion The"blizzard"appearance was an characteristic ultrasonic appearance of SGL,which was helpful to diagnosis of SGL.