超声对胆管癌淋巴结转移的诊断价值

目的 完善超声对胆管癌TNM分期的诊断研究。方法 观察73例胆管癌患者肿大淋巴结声像图特征，并根据胆管肿瘤部位将肿大淋巴结的部分为四个区域。结果 超声显示淋巴结肿大31例，转移23例，炎症6例；诊断敏感性71.8%，特异性80.4%，诊断正确率76.7%。转移淋巴结多边缘不清晰（65.2%)，炎症淋巴结边缘多清晰（83.0%)，在大小、回声、形态方面两组无明显差异。结论 超声为诊断胆管癌淋巴结转移的良好手段，重视淋巴结边缘形态及浸润征象有助于鉴别诊断，超声能准确地判断巴结部位及分区，为术前分期诊断提供依据。

Value of ultrasonograpy in diagnosing metastatic lympha nodes of cholangiocarcinoma

Objective To improve the ability of ultrasonography to demonstrate pleiades,and its diagnosing rate.Methods Evaluation the sonographic characteristics of those pleiades of cholangiocarcinoma.All the lympha nodes were classified into four areas according to the situs of the carcinoma.Results Thirty one cases of adenophyma,23 cases of metastasis,and 6 cases of inflammation were revealed.The diagnostic sensitivity was 71.8% ,the specificity was 80.4% ,accuracy was 76.7% .Analyzing the sonograms,metastatic lympha nodes always had blur edges ( 65.2% ),but those inflammatory lympha nodes mostly had clear fringe.But there was no significant difference in size,echogenicity and morphology between those two groups.Conclusions Ultrasonography is a useful method in diagnosing metastatic lympha nodes of cholangiocarcinoma.Respecting the edge and other infiltrate signs of lympha nodes will be helpful in identification.Ultrasound can locate lympha nodes more accurately,so it can provide data for tumor staging before surgery.