彩色多普勒超声在颈部淋巴结疾病诊断中的应用

目的 探讨彩色多普勒超声血管模式在颈部淋巴结病变检测中的应用价值。方法 用彩色多普勒超声观察113例患者的120个淋巴结。将淋巴结分为4组：反应性淋巴结25个、结核性淋巴结14个、淋巴瘤41个和转移性淋巴结40个。将有血供淋巴结的血管模式分为淋巴门型、中央型、边缘型和混合型等4种类型。结果 92．0％的反应性淋巴结和75．6％的淋巴瘤出现淋巴门血流，有75．6％的淋巴瘤出现淋巴结边缘血流；转移性淋巴结有60．0％在淋巴结中央显示血流，57．5％在边缘出现血流；结核性淋巴结的血流分布和恶性淋巴结相似。2个反应性淋巴结、1个结核性淋巴结为无血供。结论 颈淋巴结中央血流和边缘血流主要见于恶性病变，淋巴门血流常意味着良性病变，但是这些血流分布特点在良恶性淋巴结病变中有交叉。

Color Doppler ultrasonography for evaluation of cervical lymphadenopathy

Objective To evaluate the usefulness of color Doppler ultrasonography in differential diagnosis of cervical lymphadenopathy by depicting the intranodal vascular pattern. Methods One hundred and twenty lymph node lesions in 113 patients who underwent color Doppler flow imaging were grouped as reactive lymphadenitis ( n =25), tuberculosis ( n =14), lymphoma ( n =41), and metastasis ( n =40). The vascular patterns of hilar type, central type, peripheral type and mixed type were assessed. Results Most reactive lymph nodes( 92.0%) and lymphomatous nodes( 75.6%) showed hilar vessels,lymphomatous nodes also frequently demonstrated peripheral vessels( 75.6%).Central vessels or peripheral vessels were frequent in metastatic nodes( 60.0% and 57.5%, respectively).The intranodal vascular distribution in tuberculous nodes was simulated malignant disease. Avascularity was observed in 2 of 25 reactive lymph nodes and 1 of 14 tuberculous nodes. Conclusions Central vessels or peripheral vessels were mainly found in malignant lymphadenopathy,and the presence of hilar vessels is suggestive of benign lymphadenopathy. However, there is overlap of appearance between benign and malignant disease.