CEUS鉴别诊断颈部不同大小淋巴结的良恶性

目的 观察CEUS对颈部不同大小良恶性淋巴结的鉴别诊断价值。方法 将经病理证实的142枚颈部增大淋巴结（良性68枚，恶性74枚）按最大径分为<1 cm、1~2 cm和>2 cm组，行常规超声及CEUS检查，观察其常规超声特征及造影灌注模式，并与病理对照。结果 良性淋巴结55.88%（38/68）表现为均匀高增强型，26.47%（18/68）表现为有规则无灌注区的不均匀增强型或环状增强型；恶性淋巴结中72.97%（54/74）表现为有不规则灌注缺损区的不均匀增强型，14.86%（11/74）为微弱增强型。常规超声鉴别诊断<1 cm、1~2 cm和>2 cm 3组淋巴结良恶性的准确率分别为62.16%（23/37）、69.49%（41/59）和78.26%（36/46），CEUS诊断的准确率分别为81.08%（30/37）、86.44%（51/59）和86.96%（40/46）；相比常规超声，CEUS能够显著提高对最大径1~2 cm良恶性淋巴结的诊断准确率（P=0.02）。结论 CEUS对鉴别诊断良恶性淋巴结具有一定价值，尤其对最大径1~2 cm淋巴结。

CEUS in differential diagnosis of benign and malignant cervical lymph nodes with different size

Objective To investigate the value of CEUS in differential diagnosis of benign and malignant cervical lymph nodes with different size. Methods Totally 142 cervical enlarged lymph nodes (68 benign and 74 malignant nodes) confirmed by pathology were divided into 3 groups according to the maximum diameter length:<1 cm, 1-2 cm and >2 cm groups. Conventional ultrasonic characteristics and perfusion patterns of lymph nodes in 3 groups were observed and compared with pathologic findings. Results Among benign lymph nodes, 55.88% (38/68) showed uniform and high enhancement, while 26.47% (18/68) showed nonuniform or circular enhancement with regular unenhanced areas. Among malignant lymph nodes, 72.97% (54/74) showed nonuniform enhancement with irregular perfusion defects and 14.86% (11/74) showed weak enhancement. The accuracy of conventional ultrasound in differential diagnosis of benign and malignant cervical lymph nodes of <1 cm, 1-2 cm, >2 cm groups were 62.16% (23/37), 69.49% (41/59) and 78.26% (36/46), of CEUS were 81.08% (30/37), 86.44% (51/59)and 86.96% (40/46).Compared with conventional ultrasound, CEUS improved diagnostic accuracy of 1-2 cm lymph node (P=0.02). Conclusion CEUS is valuable for differential diagnosis of benign and malignant lymph nodes, especially for 1-2 cm lymph nodes.