彩色多普勒超声对颈部淋巴结诊断价值的分析

目的探讨彩色多普勒超声(CDFI)对颈部淋巴结的诊断价值,提高彩超对不同疾病所致淋巴结肿大的鉴别诊断水平。方法应用彩超观察共62例124个颈部肿大淋巴结(分良、恶性两组)的长径与短径之比(L/S),内部回声及CDFI血流特征。结果良性肿大淋巴结形态呈椭圆形,L/S比值>2,内部回声多为髓质增强、增宽,皮质相对变窄,门部回声规则存在。恶性肿大淋巴结形态呈类圆形,L/S比值<2,内部回声以皮质低回声为主,或强弱不等或非均匀性增厚,髓质及门部强回声变形偏移、不规则或消失。CDFI示良性肿大淋巴结内多呈门部规则血流,呈低速低阻型,部分未见血流。恶性肿大淋巴结内多呈不规则血流及周边包绕血流,血流速度Vmax及阻力指数RI显著高于良性组(P<0.01)。结论根据彩色多普勒血流及二维声像图特点、结合病史等,超声检查对颈部肿大淋巴结良、恶性鉴别有一定诊断价值,可作为首选方法。

Analysis on Diagnosis for Cervix Lymph Node Using Color Doppler Flow Image

Objective To evaluate the diagnosis value of color doppler flow image for cervix lymph node and improve the diagnosis ability for differential diagnosis for benign and maligant lymphadenopathy. Method Using color doppler flow image,62 patients with 124 swelling lymph nodes(dividied into malignant group and benign group) were observed for long/short diameter ratio(L/S),inner echo and blood flow characters of CDFI. Results The outline appearance of benign enlarged lymph nodes was elliptic,with L/S>2.Regarding to their inner echo,medulla mostly became stronger,cortex became comparatively narrower,echo phenomenon in portal venous system kept in normal.In contrast,malignant lymphadenopathy was predominantly to be rotundity,with L/S<2,and inner echo was predominantly in weak cortex echo,sometimes with highly heterogeous echo intensity in medulla and portal region,abnormity or disappearance,or unevenly distributed thickening.CDFI showed that normal blood flow existed in most benign hypertrophy lymph nodes portal,with low speed,low resistance and even no blood flow in some nodes.Malignant lymphadenopathy suffered from abnormal blood flow and circumference enclosing blood flow.The maximum velocity of blood flow(Vmax) and resistance index(RI) were significantly increased in malignant group (P<0.01). Conclusion Based on color doppler flow image and two-dimension sonography combined with history,it is meaningful to distinguish malignant from benign lymphadenopathy,which can be used as the first-line diagnostic method for cervix lymphadenopathy.