实时超声弹性成像在淋巴结疾病诊断中的应用

目的探讨实时超声弹性成像在淋巴结疾病诊断中的应用价值。方法分析2008年2月-4月27例淋巴结疾病患者的65个淋巴结病灶超声弹性图表现,弹性图分级为0～Ⅳ级,弹性图分型为Ⅰ～Ⅲ型。所有淋巴结均经术后病理学或细针抽吸细胞学检查证实,或经随访证实。结果转移性淋巴结弹性分级较高,≥Ⅲ级11/13,占84.62%;淋巴瘤性淋巴结弹性分级较低,≤Ⅱ级16/21,占76.19%。转移性淋巴结中Ⅱ型7/13,占53.85%,转移性淋巴结占全部Ⅱb型的54.55%（6/11）;淋巴瘤性淋巴结中Ⅱ型13/21,占61.90%,淋巴瘤性淋巴结占全部Ⅱa型的73.33%（11/15）;反应性淋巴结占全部Ⅰa型的68.18%（15/22）。结论实时超声弹性成像能为淋巴结疾病的诊断提供一定信息,弹性图分级对鉴别良恶性淋巴结有统计学意义,分型对于鉴别特定类型淋巴结疾病有一定提示作用。

Preliminary Study of Real-Time Elastography in the Diagnosis of Lymph Node Diseases

Objective To study real-time elastography in the diagnosis of lymph nodes diseases.Methods The elastograms of 65 lymph nodes in 27 patients were evaluated from February to April 2008.Elastography was classified into grade 0-Ⅳ and type Ⅰ-Ⅲ.All lymph nodes were confirmed by histology or fine-needle aspiration cytology,or follow-up.Results The metastatic lymph nodes with elastographic grades ≥Ⅲ accounted for 84.62%（11/13）;The lymphoma lymph nodes with elastographic grade ≤Ⅱ accounted for 76.19%（16/21）.Metastatic lymph nodes in type Ⅱ accounted for 53.85%（7/13）,and metastatic lymph nodes accounted for 54.55%（6/11）of type Ⅱb.Lymph nodes from lymphoma in type Ⅱ accounted for 61.90%（13/21）,and lymph nodes from lymphoma accounted for 73.33%（11/15）of type Ⅱa.Reactive lymph nodes accounted for 68.18%（15/22）of type Ⅰa.Conclusion Real-time elastography can provide some useful information in the diagnosis of lymph node diseases.Elastographic grading is of value in differential diagnosis between benign and malignant lymph nodes,and the typing of elastograms may play a certain role in identifying the specific type of lymph nodes.