【摘要】 目的探讨超声造影在浅表淋巴结疾病鉴别诊断中的应用价值。方法对43例患者的75个浅表肿大淋巴结(良性28个,转移性39个,淋巴瘤8个)进行常规二维、彩色多普勒超声检查和灰阶超声造影,观察淋巴结造影剂灌注特征,并与病理对照,比较造影前后超声诊断的准确性。结果良性淋巴结中57%(16/28)造影表现为均匀增强型,36%(10/28)表现为淋巴门不均匀增强型;转移性淋巴结中77%(30/39)表现为实质不均匀增强型,21%(8/39)表现为微弱增强型。常规超声诊断良恶性淋巴结的敏感性70%,特异性86%,准确性75%;超声造影诊断的敏感性87%,特异性93%,准确性89%,超声造影诊断的准确率显著提高(P<0.05)。结论灰阶超声造影发现淋巴结疾病的不同灌注特征,为良恶性淋巴结疾病的鉴别诊断提供了有价值的依据。更多还原

【Abstract】 Objective To evaluate the value of contrast-enhanced ultrasound in differential diagnosis of superficial lymphadenopathy. Methods Seventy-five lymph nodes from 43 patients were studied both by conventional techniques and contrast-enhanced ultrasound. Of the lymph nodes examined, 28 were benign and 47 were malignant(39 metastases and 8 non-Hodgkin lymphomas). The enhancement of echogenicity was evaluated. The diagnosis obtained by means of surgical biopsy. Results The study using contrast-enhanced ultrasound showed intense homogeneous enhancement in 16 of 28(57) benign lymph nodes; intense but inhomogeneous enhancement in 10 of 28(36) benign lymph nodes, with perfusion defects in the echogenic hilum; intense but inhomogeneous enhancement in 30 of 39(77) metastases, with perfusion defects in the nodal parenchyma; and last, scarce intranodal enhancement in 8 of 39(21) metastases. The sensitivity, specificity, and accuracy of conventional techniques in differentiation between benign and malignant lymph nodes were 70, 86,and 75 versus 87, 93,and 89 for contrast-enhanced ultrasound. The increase in correct diagnosis was significiant(P< 0.05 ) when conventional ultrasound was tested against contrast-enhanced ultrasound. Conclusions Enlarged superficial lymph nodes can be characterized as benign or malignant with high diagnosis accuracy on the basis of enhancement of echogenicity as seen on contrast-enhanced ultrasound.更多还原