颈部不同肿大淋巴结的彩色多普勒超声鉴别

目的探讨颈部淋巴结肿大二维超声及彩色多普勒血流特征与定性诊断。方法应用彩色多普勒超声观察86例患者,计132个颈部肿大淋巴结,其中反应性淋巴结52个,结核性淋巴结16个,淋巴瘤38个,转移性淋巴结癌26个。对淋巴结大小形态、内部回声、门结构、纵横比(L/T)与周围解剖关系进行分析,脉冲多普勒(PWD)检测收缩期最大血流速度(Vmax)与最小血流速度(Vmin)及阻力指数(RI)。结果反应性淋巴结与淋巴瘤的形态结构、纵横比等声像图特征相近;结核性淋巴结与转移性淋巴结癌的形态结构等声像图特征相近。多普勒血流检测:Vmax、Vmin、RI组间比较均有显著性差异(P<0.05)。结论反应性淋巴结与淋巴瘤之间、结核性淋巴结与转移性淋巴结癌之间单凭声像图特征难以鉴别,需结合多普勒血流特征及临床体征综合鉴别。

Differential diagnosis of cervical lymphadenophathy with color Doppler sonography findings

Objective To investigate the characteristics and the method of differential diagnosis with color Doppler flow imaging for cervical lymphadenophathy. Methods The data of 86 cases with 132 lesions were retrospectively analysed. which were grouped into lymph node reactive hyperplasia (52 lesions), tuberculous lymphadenitis (16 lesions), malignant lymphoma (38 lesions) and lymph node metastasis (26 lesions). lymph-nodes morphology, interal echoes, pattern of hilar, longitudinal-transversal proportion and the relationship with its consecutive aera were comprehensively analysed. The maximum blood flow velocity (Vmax), minimum blood flow velocity (Vmin), resistance index (RI) were detected. Results Lymph node reactive hyperplasia and malignant lymphoma, tuberculous lymphadenitis and lymph node metastasis had the same sonographic features, but there was markedly significant difference in Vmax, Vmin, RI between two groups. Conclusion It is difficult to diagnose lymph node reactive hyperplasia from malignant lymphoma, tuberculous lymphadenitis from lymph node metastasis, which should be combined with color Doppler sonography and clinical symptoms.