二维髓质、三维血流及弹性成像对颈部肿大淋巴结鉴别诊断的价值探讨

发布时间：2018-06-29 23:29

本文选题：颈部淋巴结 + 超声检查　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：探讨二维髓质、三维血流及弹性成像对颈部肿大淋巴结良恶性鉴别诊断的临床应用价值。方法：对73例患者的100个颈部肿大淋巴结分别进行二维灰阶超声(B超)、三维彩色能量多普勒(3D-CDE)及弹性成像(UE)检查。所有淋巴结经病理及随访证实分为良性组(淋巴结核、淋巴结炎及反应性增生淋巴结)和恶性组(淋巴瘤和转移性淋巴结),观察二维髓质位置形态、三维血流分布模式及反映组织硬度的弹性成像图,评价这三种技术对颈部肿大淋巴结进行良恶性鉴别的诊断效能并分析两组超声声像图特点。结果：100个颈部肿大淋巴结,B超、3D-CDE、UE诊断淋巴结良恶性的灵敏度、特异度及准确度分别为87.9%,71.4%,81.0%；94.8%,85.7%,91.0%；89.7%,83.3%,87.0%；B超、3D-CDE及UE联合(并联)诊断淋巴结良恶性的灵敏度、特异度及准确度分别为96.6%,66.7%,77.0%；三种检查技术的声像图特征在鉴别良恶性颈部淋巴结方面差异均有统计学意义(P0.05)；各超声征象与病理吻合程度的Kappa值分别为0.592,0.893,0.707。结论：三维血流分布模式的诊断效能最高,临床应用价值最好。弹性成像硬度分级对颈部淋巴结的鉴别诊断具有一定价值,与二维髓质比较价值更大,有望成为鉴别诊断颈部淋巴结病变的一项重要新手段。
[Abstract]:Objective: to evaluate the clinical value of two-dimensional medulla, three-dimensional blood flow and elastic imaging in differential diagnosis of benign and malignant cervical lymph nodes. Methods: 100 enlarged cervical lymph nodes of 73 patients were examined by two dimensional gray scale ultrasound (B US), three dimensional color energy Doppler (3D-CDE) and elastic imaging (UE). All lymph nodes were divided into benign group (lymph node nucleus, lymphadenitis and reactive hyperplasia lymph node) and malignant group (lymphoma and metastatic lymph node) by pathology and follow up. Three-dimensional blood flow pattern and elastic imaging images reflecting tissue hardness were used to evaluate the diagnostic efficacy of these three techniques in differentiating benign and malignant cervical lymph nodes and to analyze the characteristics of two groups of ultrasound images. Results: the sensitivity, specificity and accuracy in the diagnosis of benign and malignant lymph nodes were 87.9% and 71.4%, respectively. The sensitivity, specificity and accuracy of B-ultrasound 3D-CDEU UE in the diagnosis of benign and malignant lymph nodes were 87.9%, 71.4% and 91.0%, 91.0%, 83.33% and 87.0%, respectively, and the sensitivity of 3D-CDE and UE combined with UE in the diagnosis of benign and malignant lymph nodes were analyzed, and the sensitivity of 3D-CDE and UE combined with UE in the diagnosis of benign and malignant lymph nodes were analyzed. The specificity and accuracy were 96.66.70.The sonographic features of the three examination techniques were significantly different in differentiating benign and malignant cervical lymph nodes (P0.05); the Kappa values of each ultrasound sign and pathological coincidence were 0.5920.893n0.707 respectively. Conclusion: the three-dimensional blood flow distribution model has the highest diagnostic efficacy and the best clinical application value. Elastic imaging hardness grading has a certain value in the differential diagnosis of cervical lymph nodes and is more valuable than two-dimensional medulla. It is expected to be an important new method in the differential diagnosis of cervical lymph node lesions.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1

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