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浅表淋巴结病变彩色超声检查的临床应用

Diagnosis of Benign and Malignant Superficial Lymphadenopathy Using Conventional and Color Doppler Sonography

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【作者】 侯新燕张武

【Author】 Ho Xinyan;Zhang Wu(The Third Hospital of Beijing Medical University 100083)

【机构】 北京医科大学张三医院超声科

【摘要】 本文共检查67例,237个肿大浅表淋巴结(良性140个,恶性97个)。全部病例经超声引导穿刺和/或手术活检病理证实。同期选择健康者30例,120个颈部淋巴结为对照组。结果表明,正常淋巴结的2D、CDI表现及PW参数与异常淋巴结相比差别显著;正常淋巴结短径≤0.5cm是一个重要的鉴别指标。在异常淋巴结中,良恶性淋巴结的2D表现如皮质、髓质和门部的改变以及诸测量参数如L、S、L/S比值等具有各自的特性。但仍具有其局限性,尤以结核性易与恶性病变相混淆。CDI和DPI显示良性淋巴结与恶性淋巴结具有显然不同的血流分布形态,结合PW参数中Vmax和RI有助于进一步区分淋巴结的良恶性病变。

【Abstract】 SixiY-seven patients’237 superficial lymph nodes lesions suspected were evaluated by 2-Dimensional ultrasound arid color Doppler sonography(CDI,DPI,PW).All the patients accepted biopsy and/or surgery and had pathologic results.140 benign and 97 malignant lymph nodes were found.There were 120 normal cervical lymph nodes in 30 healthy people as a control group.Results showed that differentiation of normal and abnormal superficial lymph nodes were facilitated by using high-resolution US.The short axis of lymph node with≤5 mm in diameter showed high sensitivity,specificity and accuracy for diagnosing normal lymph node.It also showed that some different sonomorphologic features of lymph nodes existed in benign and malignant groups,such as the measurements of long axis,short axis and L/S ratio;and echotexture changes of their cortex,medulla hilus.Hower,these findings did have some limitations in differential diagnosis,especially between tuberculous and malignant lesion. We found that by using CDI,DPI combined with specturm analysis of PW Doppler,some different blood flow patterns and hemodynamic parameters such as maximal systolic flow velocities and resistance index were helpful for making further differential diagnosis.

  • 【文献出处】 中国超声医学杂志 ,CHINESE JOURNAL OF ULTRASOUND IN MEDICINE , 编辑部邮箱 ,1996年S1期
  • 【分类号】R445.1
  • 【被引频次】33
  • 【下载频次】67
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