恶性浅表淋巴结病变的常规超声及超声造影特征

目的探讨与恶性浅表淋巴结病变相关的常规超声及经静脉超声造影(CEUS)特征。资料与方法对68例患者共68枚淋巴结进行常规超声检查,并对其中62枚行CEUS检查,所有淋巴结均获取病理结果。比较良、恶性浅表淋巴结的常规超声及CEUS特征差异,对各因素分别做受试者工作特征(ROC)曲线,计算其对良、恶性淋巴结病变的鉴别诊断效能。结果良性和恶性浅表淋巴结病变短径、长短径之比、有无淋巴门、周围型/混合型血流、增强是否均匀、增强时有无淋巴门、外周向中心增强、增强时有无灌注缺损等超声特征比较,差异均有统计学意义(P均<0.05),其对良、恶性淋巴结病变的ROC曲线下面积分别为0.687、0.665、0.786、0.676、0.628、0.662、0.725和0.648。结论浅表淋巴结病变短径、长短径之比、有无淋巴门、周围型/混合型血流、增强是否均匀、增强时有无淋巴门、外周向中心增强、增强时有无灌注缺损等超声特征是鉴别诊断良恶性的指标。

Conventional Ultrasound and Contrast-Enhanced Ultrasound Features of Malignant Superficial Lymph Node Lesions

Purpose To explore the features of conventional ultrasound and contrast-enhanced transvenous ultrasound(CEUS)associated with malignant superficial lymph node lesions.Materials and Methods Sixty-eight lymph nodes of 68 patients were routinely examined by ultrasound,and 62 of them were examined by CEUS.Pathological results were obtained for all lymph nodes.The features of conventional ultrasound and CEUS between benign and malignant superficial lymph nodes were compared,and receiver operating characteristic(ROC)curve was drawn for each factor,then its differential diagnosis efficiency for benign and malignant lymph node lesions was calculated.Results There were significant differences in the short diameter,the aspect ratio,the absence of lymphatic hilum,the peripheral/mixed blood flow on conventional ultrasound,nonhomogeneous enhancement,the absence of lymphatic hilum at the time of enhancement,peripheral to central enhancement,and perfusion defect on contrast-enhanced ultrasound between benign and malignant superficial lymph nodes(all P<0.05).The area under the ROC curve for benign and malignant lymph node lesions were 0.687,0.665,0.786,0.676,0.628,0.662,0.725 and 0.648,respectively.Conclusion The short diameter,the aspect ratio,the absence of lymphatic hilum and the peripheral/mixed blood flow on conventional ultrasound,and nonhomogeneous enhancement,the absence of lymphatic hilum at the time of enhancement,peripheral to central enhancement and perfusion defect on contrast-enhanced ultrasound of the superficial lymph node lesions are the strong indicator in the differential diagnosis of benign and malignant lesions.