【摘要】 目的 分析常规超声及超声造影(CEUS)特征对浅表淋巴结T、B淋巴瘤的鉴别诊断价值。方法 回顾性分析经病理证实的53例结内型非霍奇金淋巴瘤的常规超声及CEUS特征，包括14例T细胞淋巴瘤和39例B细胞淋巴瘤。以病理结果为金标准，通过单因素及多因素分析筛选鉴别T、B细胞淋巴瘤的独立预测因子，并构建常规超声-CEUS诊断模型；同时采用受试者工作特征曲线下面积(AUC)、灵敏度、特异度及准确度评价模型的性能。结果 淋巴结内有无网状回声、CEUS时间-强度曲线上升斜率(AS)在T、B细胞淋巴瘤的鉴别诊断中差异具有统计学意义(P<0.05),并构建常规超声-CEUS诊断模型。模型的灵敏度、特异度及准确度分别为85.71%、69.23%及73.58%,均高于淋巴结内网状回声、AS的单一诊断效能(78.57%、56.41%及62.26%,71.43%、74.36%及73.58%)。此外，常规超声-CEUS诊断模型的AUC为0.861,高于网状回声及AS的AUC(0.675、0.729),差异具有统计学意义(P<0.05)。结论 淋巴结内有网状回声、AS截断值≤5.348提示B细胞淋巴瘤可能性大。常规超声联合CEUS对T、B细胞淋巴瘤的鉴别诊断具有重要的临床应用价值。更多还原

【Abstract】 Objective To investigate the diagnostic value of conventional ultrasound and contrast-enhanced ultrasound(CEUS) features in differentiating T-cell and B-cell lymphomas of superficial lymph nodes. Methods A retrospective analysis was performed on 53 non-Hodgkin lymphoma confirmed by pathology, including 14 cases of T-cell lymphoma and 39 cases of B-cell lymphoma. Conventional ultrasound and CEUS feature were evaluated. With pathology results as the gold standard, independent predictors for differentiating T-cell and B-cell lymphomas were identified through univariate and multivariate analyses. A diagnostic model combining conventional ultrasound and CEUS was constructed. The diagnostic performance of the model was assessed using the area under the receiver operating characteristic curve(AUC), sensitivity, specificity, and accuracy. Results The presence of reticular echoes within the lymph nodes and the ascending slope(AS) of the CEUS time-intensity curve(TIC) were statistically significant in differentiating T-cell and B-cell lymphomas(P<0.05). The diagnostic model combining conventional ultrasound and CEUS achieved a sensitivity of 85.71%, specificity of 69.23%, and accuracy of 73.58%, which were higher than those of the individual diagnostic indicators of reticular echoes(sensitivity 78.57%, specificity 56.41%, accuracy 62.26%) and TIC AS(sensitivity 71.43%, specificity 74.36%, accuracy 73.58%). The AUC of the combined diagnostic model was 0.861, which was significantly higher than that of reticular echoes(AUC 0.675) and TIC AS(AUC 0.729)(P<0.05). Conclusions The presence of reticular echoes within the lymph nodes and an AS of the TIC ≤5.348 suggest a higher likelihood of B-cell lymphoma. The combination of conventional ultrasound and CEUS has significant clinical value in the differential diagnosis of T-cell and B-cell lymphomas.更多还原