超声、MRI诊断浅表淋巴结疾病的临床价值探析

Clinical Value of MRI And Ultrasonography in The Diagnosis of Superficial Lymph Node Diseases

目的探析超声、MR诊断浅表淋巴结疾病的临床价值。方法以本院2014年5月至2018年1月68例因浅表淋巴结肿大但病因待查患者为研究对象,均接受MRI及弥散加权成像(DWI)、超声检查,分析其上述影像学表现特征,并以病理学诊断结果为金标准,计算MRI联合超声定性诊断浅表淋巴结的效能。结果经病理学明确诊断良性46例,占67.65%,以脂肪瘤、炎性淋巴结、表皮样囊肿与单纯性囊肿多见;恶性22例,占32.35%,以淋巴瘤、转移性淋巴结、脂肪肉瘤多见。MRI联合超声诊断准确率明显高于单独诊断(P<0.05)。恶性病灶形态不规则,边界粗糙不清,皮质回声宽阔型,内部回声低或无,与良性病灶相比差异均有统计学意义(P<0.05);且与良性病灶相比,恶性病灶内血流信号分级更高(P<0.05)。与良性病灶相比,恶性病灶囊性变、环形强化检出率明显高,ADC值显著低(P<0.05)。结论不同性质浅表淋巴结疾病具有一定MRI、超声特征,二者均可作为定性诊断的重要辅助手段,且MRI联合超声检查可有效提高定性诊断效能。

Objective To explore the clinical value of MRI and ultrasonograph in the diagnosis of superficial lymphadenopathy.Methods 68 patients with superficial lymph node enlargement who were admitted to our hospital from May 2014 to January 2018 were selected as the research objects.All patients were examined by MRI,diffusion weighted imaging(DWI),and ultrasound.The imaging features were analyzed,and the diagnostic efficacy of MRI combined with ultrasound in the qualitative diagnosis of superficial lymph nodes was calculated based on the pathological diagnosis results.Results 46 patients were diagnosed as benign by pathology,accounting for 67.65%.Lipoma,inflammatory lymph nodes,epidermoid cyst and simple cyst were common.There were 22 cases of malignant tumors,accounting for 32.35%.Lymphoma,metastatic lymph nodes and liposarcoma were more common.The diagnostic accuracy of ultrasound combined with MRI was significantly higher than that of MRI alone(P<0.05).Compared with benign lesions,malignant lesions had irregular shape,rough boundary,broad cortical echo,low or no internal echo,and the difference was statistically significant(P<0.05);And compared with benign lesions,the blood flow signal classification were higher(P<0.05).Compared with benign lesions,the detection rate of cystic change and ring enhancement in malignant lesions was significantly higher,and the ADC value was significantly lower(P<0.05).Conclusion Benign and malignant superficial lymph node diseases have certain MRI and ultrasound features,both of which can be used as an important auxiliary means of qualitative diagnosis,and MRI combined with ultrasound can effectively improve the effectiveness of qualitative diagnosis.