彩超对腹膜后肿大淋巴结良恶性的鉴别诊断价值

目的探讨超声诊断腹膜后肿大后淋巴结良恶性病变的声像图特征与临床实用价值。方法对48例(95枚)腹膜后淋巴结肿大的患者在行组织活检前应用彩超观察内部回声,血流特点,大小及其形态特征,多普勒测值(收缩期最大血流速度、舒张末期血流速度、阻力指数等改变)结果良性肿大淋巴结多呈椭圆形,内部回声尚均质,但结核性肿大淋巴结内见钙化强回声及液化,并破溃与周围组织粘连成团,界限不清,血流为零星,阻力指数在0.42~0.55,为低阻力型;恶性肿大淋巴结多呈类圆形及圆形,内部回声不均匀、稍低,边界欠规则,血流极其丰富,有者达包膜下,呈树枝状分布,走形迂曲,阻力指数0.59~0.79,为高阻力型。结论通过对淋巴结超声测值即大小及形态特征,结合内部回声,与周围组织关系,血流分布情况,阻力指数等改变,对淋巴结良恶性鉴别具有使用价值,可作为肿大淋巴结病因诊断的首选方法,并为进一步穿刺活检及超声造影提供依据。

Ultrasound of the Retroperitoneal Lymph Nodes in the Differential Diagnosis of Benign and Malignant

Objective To investigate the ultrasonic diagnosis of retroperitoneal lymph node enlargement of benign and malignant lesions after the sonographic features and clinical value.Methods 48 patients(95) patients with retroperitoneal lymph nodes biopsy of the line before the application of ultrasound observed internal echo,blood flow characteristics,size and morphology,Doppler values(systolic blood flow velocity,end diastolic velocity,resistance index change) Result Benign enlargement of the lymph nodes mostly oval,homogeneous internal echoes still,but the tuberculous lymph nodes were seen in hyperechoic calcification and liquefaction,and rupture into the surrounding tissue adhesion groups,ill-defined,blood flow is sporadic,resistance index of 0.42 to 0.55 for the low resistance type;malignant lymph nodes mostly oval and round,heterogeneous internal echo,lower boundary due to the rules,the blood flow extremely rich,there are those of the capsule,dendritic distribution,out of shape and tortuous,and resistance index from 0.59 to 0.79 for the high resistance type.Conclusion The value of ultrasound measurements of lymph node size and morphological characteristics that,combined with internal echoes,the relationship with the surrounding tissue,the distribution of blood flow,resistance index changes,the identification of benign and malignant lymph nodes have a value,as the etiological diagnosis of lymph nodes preferred method,and further biopsy and ultrasound imaging to provide a basis.