超声造影及常规超声在肺癌新发锁骨上淋巴结定性诊断中的应用价值

Application value of contrast-enhanced ultrasound and conventional ultrasound in qualitative diagnosis of newly developed supraclavicular lymph nodes in lung cancer

目的探讨超声造影(CEUS)及常规超声(US)对肺癌患者新发锁骨上淋巴结定性诊断的价值。方法选取余姚市人民医院行锁骨上淋巴结病理穿刺的68例肺癌患者进行US和CEUS检查,均为新发锁骨上淋巴结、经病理活检明确诊断。根据淋巴结病理诊断结果,将患者分为良性组及恶性组,对比2组淋巴结超声表现,ROC曲线分析US及CEUS的诊断效能。结果恶性组与良性组髓质结构不清晰的比例(89.29%、52.50%)、CDFI血流类型、CEUS强化模式,差异有统计学意义(χ^(2)=8.57、8.52、20.31,均P<0.05)。US及CEUS对淋巴结定性诊断的ROC曲线下面积(AUC)分别为0.68(0.54~0.81)、0.75(0.63~0.88)。结论肺癌患者新发良性与恶性锁骨上淋巴结间髓质结构、CDFI血流类型及CEUS增强模式存在差异。US及CEUS特征与淋巴结转移密切相关,两者对肺癌患者新发锁骨上淋巴结的定性诊断具有一定的价值。

Objective To explore the diagnostic value of contrast-enhanced ultrasound(CEUS)and conventional ultrasound(US)in the qualitative diagnosis of newly developed supraclavicular lymph nodes in lung cancer patients.Methods 68 lung cancer patients who underwent supraclavicular lymph node biopsy were selected for US and CEUS examination,all of whom had newly developed supraclavicular lymph nodes and confirmed diagnoses by pathological biopsy.According to the pathological diagnosis results,patients were divided into benign and malignant groups,and the ultrasound characteristics of the lymph nodes were compared.The diagnostic efficacy of US and CEUS was analyzed by ROC curve.Results There were significant differences in the proportion of unclear medullary structures(89.29%,52.50%),CDFI blood flow type,and CEUS enhancement mode between the malignant and benign groups(χ^(2)=8.57,8.52,20.31,both P<0.05).The areas under the ROC curve(AUC)of US and CEUS for lymph node qualitative diagnosis were 0.68(0.54~0.81)and 0.75(0.63~0.88),respectively.Conclusions There are differences in medullary structure,CDFI blood flow type,and CEUS enhancement mode between newly developed benign and malignant supraclavicular lymph nodes in lung cancer patients.The US and CEUS features are closely related to lymph node metastasis and have certain value in the qualitative diagnosis of newly developed supraclavicular lymph nodes in lung cancer patients.