实时剪切波弹性成像评价颈部及腋窝淋巴结硬度

发布时间：2018-06-22 20:58

本文选题：淋巴结 + 弹性成像技术　；参考：《中国医学影像技术》2015年03期

【摘要】：目的探讨应用剪切波弹性成像(SWE)技术测定的颈部及腋窝淋巴结弹性模量值鉴别诊断正常与恶性淋巴结的价值。方法选取经穿刺活检或手术证实颈部及腋窝恶性淋巴结患者72例以及80名正常人,分别纳入恶性及正常浅表淋巴结各100个,其中颈部淋巴结各60个,腋窝淋巴结各40个,于术前进行实时剪切波弹性成像,获取淋巴结弹性模量值,分析比较颈部及腋窝正常、恶性淋巴结间弹性值的差异;以病理结果为"金标准",分别绘制并分析采用颈部、腋窝淋巴结弹性模量平均值诊断恶性淋巴结的ROC曲线,评价诊断效能。结果颈部正常淋巴结的弹性模量平均值为(18.94±5.20)kPa,恶性淋巴结为(25.48±5.36)kPa,腋窝正常淋巴结的弹性模量平均值为(11.68±2.27)kPa,恶性淋巴结为(19.71±3.93)kPa,颈部正常、恶性淋巴结的弹性模量平均值均分别高于腋窝正常、恶性淋巴结(P均0.01),同一部位(颈部、腋窝)的恶性淋巴结弹性平均值均高于正常淋巴结(P均0.01)。应用颈部淋巴结弹性模量平均值诊断恶性淋巴结,ROC曲线下面积(AUC)为0.81,以19.15kPa为诊断界值时,敏感度为93.3%,特异度为65.0%。应用腋窝淋巴结弹性模量平均值诊断恶性淋巴结,AUC为0.98,以13.95kPa为诊断界值时,敏感度为97.5%,特异度为87.50%。结论SWE弹性模量平均值可以为颈部及腋窝正常与恶性淋巴结的鉴别诊断提供依据。
[Abstract]:Objective to evaluate the value of elastic modulus of cervical and axillary lymph nodes in differential diagnosis of normal and malignant lymph nodes by using shear wave elastic imaging (SWE). Methods Seventy-two patients with cervical and axillary lymph nodes confirmed by puncture biopsy or operation and 80 normal controls were included in the study, including 100 malignant and normal superficial lymph nodes, including 60 cervical lymph nodes and 40 axillary lymph nodes, respectively. Real time shear wave elastic imaging was performed before operation to obtain the elastic modulus of lymph nodes, and to analyze and compare the difference of elastic modulus between the cervical and axillary lymph nodes, and to draw and analyze the neck according to the pathological results as "gold standard". The mean value of modulus of elasticity in axillary lymph nodes was evaluated by ROC curve for diagnosis of malignant lymph nodes. Results the average elastic modulus of normal lymph nodes was (18.94 卤5.20) KPA, malignant lymph nodes (25.48 卤5.36) KPA, axillary lymph nodes (11.68 卤2.27) KPA and malignant lymph nodes (19.71 卤3.93) KPA. The mean elastic modulus of malignant lymph nodes was higher than that of axillary lymph nodes (P0.01), and that of the same lymph nodes (neck, axillary) was higher than that of normal lymph nodes (P0.01). The area under the ROC curve (AUC) of cervical lymph nodes was 0.81.The sensitivity was 93.3and the specificity was 65.0 when 19.15kPa was used as the diagnostic threshold. The mean value of elastic modulus of axillary lymph nodes in diagnosis of malignant lymph nodes was 0.98. When the diagnostic threshold was 13.95 KPA, the sensitivity was 97.5 and the specificity was 87.50. Conclusion the average elastic modulus of SWE can provide evidence for differential diagnosis of normal and malignant lymph nodes in neck and axilla.
【作者单位】：中国医科大学附属第一医院超声科;
【分类号】：R445.1;R730.4

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