超声造影在颈部异常淋巴结诊断中的应用价值

发布时间：2019-04-02 01:45

【摘要】：目的：探讨超声造影(CEUS)对颈部异常淋巴结鉴别诊断的价值,为临床诊疗提供更有价值的信息。方法：利用高频彩色多普勒超声及CEUS技术对29例颈部淋巴结肿大患者进行术前检查，，对淋巴结的高频彩色多普勒超声相关特征及CEUS的造影剂到达时间（AT）、达峰时间（TTP）、增强表现形式、增强模式及充盈缺损情况进行记录，并作出高频彩色多普勒超声诊断，及其联合CUES诊断，术后取得病理结果29枚，以病理结果为金标准分为良性淋巴结和恶性淋巴结两组。对CEUS所观测指标：AT、TTP采用t检验，P0.05为差异有统计学意义；增强表现形式、增强模式及充盈缺损情况采用χ2检验，P0.05为差异有统计学意义。病理结果与以上诊断检查结果进行对照，分析比较高频彩色多普勒超声与高频彩色多普勒超声联合CEUS诊断颈部淋巴结良恶性的准确性、特异性及敏感性。结果：（1）CEUS相关参数：AT及TTP差异无统计学意义（P0.05）；增强表现形式、增强模式及充盈缺损情况差异有统计学意义（P0.05）。（2）高频彩色多普勒超声与高频彩色多普勒超声联合CEUS诊断颈部淋巴结良恶性的准确性、特异性、敏感性比较，高频彩色多普勒超声与CEUS联合检查诊断的准确性、特异性、敏感性较高频彩色多普勒超声明显提高。进行χ2检验后，比较其准确性、特异性、敏感性差异均有统计学意义(P0.05)。结论：（1）CEUS对颈部淋巴结进行良恶性鉴别诊断，在增强表现形式、增强模式及内部充盈缺损情况等方面提供有用的信息，明显提高了诊断的准确性、特异性、敏感性。在高频彩色多普勒超声的基础上联合CEUS有助于提高诊断的准确性，降低误诊率。（2）CEUS客观的反映淋巴结内部微细血流信号及病理变化，一定程度上弥补了高频彩超的不足，在鉴别颈部淋巴结中具有较好的临床诊断价值。
[Abstract]:Objective: to evaluate the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of cervical abnormal lymph nodes and to provide more valuable information for clinical diagnosis and treatment. Methods: twenty-nine patients with cervical lymphadenopathy were examined by high-frequency color Doppler ultrasound and CEUS before operation. The characteristics of high-frequency color Doppler ultrasound and the time of arrival of contrast medium (AT), peak time (TTP), of CEUS were performed in 29 patients with cervical lymphadenopathy. Contrast-enhanced manifestations, enhancement patterns and filling defects were recorded, and high-frequency color Doppler ultrasound diagnosis, combined with CUES diagnosis, were made. 29 pathological results were obtained after operation. The pathological results were divided into benign lymph nodes and malignant lymph nodes according to the gold standard. The observed indexes of CEUS: t-test was used for AT,TTP, P0.05 was statistically significant; 蠂 2 test was used for enhanced manifestation, enhancement pattern and filling defect, P0.05 was statistically significant. The accuracy, specificity and sensitivity of high-frequency color Doppler ultrasound and high-frequency color Doppler ultrasound combined with CEUS in the diagnosis of benign and malignant cervical lymph nodes were analyzed and compared. Results: (1) CEUS parameters: there was no significant difference in AT and TTP (P0.05). There was significant difference in contrast-enhanced manifestation, enhancement pattern and filling defect (P0.05). (- 2) between high-frequency color Doppler ultrasound and high-frequency color Doppler ultrasound combined with CEUS in the diagnosis of cervical lymph node benign and malignant. The diagnostic accuracy, specificity and sensitivity of high-frequency color Doppler ultrasound combined with CEUS were significantly higher than those of high-frequency color Doppler ultrasound. After 蠂 2 test, the difference of accuracy, specificity and sensitivity was statistically significant (P0.05). Conclusion: (1) CEUS can be used to differentiate benign and malignant cervical lymph nodes, and provide useful information in the aspects of enhanced manifestations, enhancement patterns and internal filling defects, which can significantly improve the accuracy, specificity and sensitivity of the diagnosis. Combining with CEUS on the basis of high-frequency color Doppler ultrasound is helpful to improve the accuracy of diagnosis and reduce the rate of misdiagnosis. (2) CEUS objectively reflects the micro-blood flow signal and pathological changes in lymph nodes, which makes up for the deficiency of high-frequency color Doppler ultrasound to a certain extent. It has good clinical value in the differential diagnosis of cervical lymph nodes.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R551.2

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