超声弹性成像在浅表淋巴结良恶性鉴别诊断中的价值

目的：探讨实时静态超声弹性成像对判断浅表淋巴结良恶性的诊断价值.方法：2012年1月--2012年12月上海交通大学附属胸科医院诊治98例浅表淋巴结肿大患者,共107个肿大浅表淋巴结.107个肿大的浅表淋巴结均经病理学证实其良恶性.采用灰阶超声进行病灶检查,记录淋巴结的长、短径,并计算其比值.对病灶行超声弹性成像,将感兴趣区域（ROI）内病灶区与周围组织硬度相比较,并对弹性图进行分型.结果：恶性淋巴结弹性分级≥Ⅲ级者占77.33％（58/75）,良性淋巴结弹性分级≤Ⅱ级者占68.75％（22/32）,两者比较差异有统计学意义（P＜0.01）.恶性淋巴结长短径比＜2者占90.67％（68/75）,良性淋巴结长短径比＞2者占53.13％（17/32）,两者比较差异有统计学意义（P＜0.01）.但弹性分级与长短径比两种方法之间比较,差异无统计学意义（P＞0.05）.结论：超声弹性图分级对判断浅表淋巴结良、恶性有诊断价值,但是作为诊断方法,较淋巴结长短径比值并无明显优势.

Diagnostic Value of Elastosonography in Differentiating Benign from Malignant Superficial Lymph Nodes

Objective：To investigate the diagnostic value of static elastosonography in differentiating benign from malignant superficial lymph nodes.Methods：One hundred and seven superficial lymph nods of 98 patients diagnosed in Zhongshan Hospital of Fudan University were selected from Jan 2012 to Dec 2013.All of the superficial lymph nodes were proved to be benign or malignant by pathology.The lesions were checked,and the ratios of long/short diameter of lymph nodes were calculated using gray-scale sonography.The lesions were measured by elastosonography.The hardness of lesion tissue and surrounding tissue in region of interest （ROI） was compared and the elastography was classified.Results：In elastosonography classification,77.33％ of malignant lymph nodes were not less than class Ⅲ （58/75）,68.75％ of benign lymph nodes were no more than class Ⅱ （22/32）,the difference was statstically significant （P＜0.01）.The ratios of long/short diameter of 90.67％ malignant lymph nodes were lower than 2 （68/75）,that of 53.13％ benigh lymph nodes＇ were higher than 2 （17/32）,the difference was statstically significant （P＜0.01）.Elastosonography classification and long/short ratio had statistically significant in differentiating benign from malignant lymph node（P＜0.01）,but there was no statistical difference between these two methods （P＞0.05）.Conclusions：Elastosonography has diagnostic value in differentiating benign from malignant superficial lymph nodes,but as a diagnostic method,it has no obvious advantage over long/short ratio of lymph node.