【摘要】 目的探讨应用实时剪切波弹性成像(SWE)技术鉴别诊断淋巴瘤和转移淋巴结的临床价值。方法选取55例恶性淋巴结病患者(55枚淋巴结),根据病理结果分为淋巴瘤组25例和转移组30例,于穿刺活检前行二维超声和彩色多普勒超声检查,记录淋巴结最大长短径、纵横比、有无淋巴门、单/多发、边界、有无融合;然后切换至SWE模式,测量淋巴结组织的弹性模量值,观察取样框色彩充填是否完整,分析两组淋巴结各指标的差异。应用ROC曲线评价应用弹性模量均值鉴别两种恶性淋巴结的诊断效能。结果转移组淋巴门消失患者多于淋巴瘤组,二者比较差异有统计学意义(P=0.038),而两组淋巴结在短径、纵横比及是否存在融合等方面比较差异均无统计学意义。两组取样框色彩充填是否完整且均一及弹性模量均值比较差异均有统计学意义(均P<0.05)。以18.94 k Pa为诊断界值时,应用淋巴结弹性模量均值鉴别诊断转移性淋巴结和淋巴瘤淋巴结的敏感性为83.3%,特异性为96.0%。结论 SWE获取的颈部淋巴结弹性图像和弹性模量值可为鉴别恶性淋巴结性质提供诊断依据,具有重要临床应用价值。更多还原

【Abstract】 Objective To explore the clinical value of real-time shear wave elastography(SWE) in the differential diagnosis of lymphoma and metastatic lymph nodes.Methods Fifty-five cases of malignant lymphadenopathy(55 lymph nodes)were divided into lymphoma group(25 cases) and metastasis group(30 cases). Conventional ultrasound and color Doppler ultrasound were performed before biopsy.The long and short diameter,the ratio of long to short diameter,with or without hilus,single/multiple,border,with or without fusion were recorded.Then the Young’s modulus of lymph nodes were measured by SWE,whether the sampling box color filling completed was observed.The differences of the indicators between the two groups were analyzed.The diagnostic efficiency for the two kinds of malignant lymph nodes was identified by the ROC curve with the mean of Young’s modulus.Results There was statistical difference of hilus absense between lymphoma group and metastasis group(P=0.038),there was no significant difference between the two groups in the short diameter,ratio of long to short diameter and the existence of fusion.Whether the sampling frame filled with colors completed and mean of Young’s modulus had statistical significant difference between two groups(P<0.05).Taking 18.94 k Pa as the cut off value,the mean of Young’s modulus of lymph nodes could achieve sensitivity of 83.3% and specificity of 96.0% in identification of lymphoma and metastatic lymph nodes.Conclusion The elastography images and Young’s modulus of cervical lymph nodes by SWE can provide diagnostic bases for the identification of malignant lymph nodes,which has important clinical application value.更多还原