基于超声造影指标颈部淋巴结穿刺活检适应证的临床研究

目的:探讨超声造影指标作为颈部淋巴结穿刺活检适应证的临床应用价值。方法: 纳入行淋巴结穿刺活检患者103例，男性47例， 女性56例，平均年龄(51.6 ± 17.9) 岁 。术前行超声造影检查，统计分析起始强化部位、强化类型两个超声造影指标作为穿刺活检适应证的统计学效能。结果:入组157枚淋巴结，炎性反应增生淋巴结 48枚，淋巴结核46枚，转移性淋巴结55枚，淋巴瘤8枚。以周边起始强化或不均匀强化超声造影指标作为穿刺活检适应证，其准确率为81.53%，敏感度为82.18%，特异度为80.35%，阳性预测值为88.30%，阴性预测值为71.4%。结论: 以周边起始强化或不均匀强化超声造影表现作为颈部淋巴结穿刺活检适应证具有较好的统计学效能，能够指导临床医师选择合适的活检方法，避免漏诊或误诊。

Clinical study of indications of cervical lymph node biopsy guided by contrast - enhanced ultrasonography

Objective: To evaluate the clinical value of contrast-enhanced ultrasonography as indications of cervical lymph node biopsy. Methods: One hundred and three patients with cervical lymphadenopathy were selected, with 47 males and 56 females, and with mean age of (51.6±17.9) years old. Before lymph node biopsy was carried out, the contrast-enhanced ultrasonography was performed on 103 patients. The statistical performance was analyzed by using the initial enhancement site and the enhancement type as indications of neck lymph node biopsy. Results: Among the 157 lymph nodes, there were 48 inflammatory lymph nodes, 46 lymph node tuberculosis, 55 metastatic lymph nodes and 8 lymphomas. The study used “peripheral” enhancement or inhomogeneous “spotted or cycle-like” enhancement showed by contrast-enhanced ultrasound as the indication of cervical lymph node biopsy. The accuracy， sensitivity， specificity， positive predictive value and negative predictive value were 81.53%， 82.18%， 80.35%， 88.30%, and 71.4%, respectively. Conclusion: Neck lymph node CEUS which shows “peripheral” enhancement or inhomogeneous “spotted or cycle-like” enhancement as the cervical lymph node puncture indication has a good statistical performance. It can guide clinicians to select the appropriate biopsy method and avoid missed diagnosis or misdiagnosis.