颈部恶性淋巴结肿大的高频及彩色多普勒超声表现

目的：用高频彩色普勒超声观察颈部恶性肿大淋巴结的形状、大小、短长径之比（Ｓ／Ｌ）、内部回声及血流信号，并评价其临床诊断价值。材料和方法：经病理证实的颈部恶性肿大淋巴结２００例，并以７０例良性肿大淋巴结对照。结果：恶性肿大淋巴结即恶性原发性肿大淋巴结（ＰＥＬＮ）及转移性肿大淋巴结（ＭＥＬＮ）多为类圆形，Ｓ／Ｌ＞０．５，回声均减低。二者内部血流信号丰富度不同，ＰＥＬＮ多为Ⅱ－Ⅲ级，ＭＥＬＮ多为Ⅰ－Ⅱ级（Ｐ＜０．０１），具有显著性差异。收缩期最高流速、舒张期最低流速及阻力指数在二者鉴别中无显著差异（Ｐ＞０．０５）。良性肿大淋巴结多扁园形回声较高，内部血流信号甚少，多为０－Ⅰ级，Ｓ／Ｌ＜０．５。结论：高频彩色多普勒显像对颈部肿大淋巴结的诊断及鉴别诊断有重要价值

Ultrasonic Imaging Using High Frequency Colopur Doppler in Enlarged Lymph Nodes of Malignant Origin

Purpose: To characterize the morphological changes songraphic findings and pattern of blood flow of the enlarged lymph nodes in the cervical region by high frequency colour Doppler ultrasonic examination, and to evaluate its clinic diagnosie value. Materials and Methods: 200 enlarged lymph nodes confirmed by pathologist as malignant in the cervical region were selected to observe the shape, size, S/L ratio of the nodes with color Doppler imaging and 70 benign lymph nodes were as control. Results: enlarged lymph nodes of primary malignancies (PELN) and those caused by metastatic lesion (MELN) were oval in shape, S/L is more than 0.5, with low echo. The intensity of bloold flow signal were higher in PELN than in MELN, and the difference between them was significant (p<0.01). The maximum blood flow velocity, the minimum blood flow velocity, and the resistance index, were not significantly different in the two groups (p>0.05). The benign lymph nodes were mostlikely to be oblate with high echo, and little internal bloold flow signal (most of them are 0 to 1 degree), the S/L is less than 0.5. Conclusion: High frequency colour Doppler sonography was of value in diagnosis and differential diagnosis of the benign and maligant lymph node.