超声造影对鼻咽癌颈部转移淋巴结的诊断价值

发布时间：2018-04-04 00:52

本文选题：超声造影　切入点：鼻咽癌　出处：《广东医学》2014年20期

【摘要】：目的探讨超声造影对鼻咽癌颈部转移淋巴结的诊断价值。方法收集30例鼻咽癌患者的119枚颈部肿大淋巴结,此119枚淋巴结均由穿刺病理证实良恶性。于鼻咽癌治疗前对目标淋巴结行常规超声检查及超声造影检查。常规超声检查通过分析淋巴结的纵横比、皮髓质结构、淋巴门情况、血流状况综合决定淋巴结的良恶性。超声造影通过观察淋巴结的增强模式(周围型、中心型、混合型)来判断淋巴结的良恶性。分析超声造影能否提高常规超声对鼻咽癌颈部淋巴结转移的诊断率。结果 30例鼻咽癌患者的119枚淋巴结经穿刺活检病理证实良性淋巴结35枚,恶性淋巴结84枚。35枚良性淋巴结中,超声造影表现为周围型增强模式的有6枚,中心型增强模式的有25枚,混合型增强模式的有4枚。84枚恶性淋巴结中,超声造影表现为周围型增强模式的有72枚,中心型增强模式的有5枚,混合型增强模式的有7枚。常规超声对淋巴结良恶性的诊断符合率为78.2%,超声造影对淋巴结良恶性的诊断符合率为87.4%,两者差异无统计学意义(醊2=3.565,P=0.085)。常规超声与超声造影联合对颈部淋巴结良恶性的诊断符合率为84.9%。结论常规超声和超声造影检查对鼻咽癌患者颈部淋巴结良恶性的鉴别诊断均有重要价值,在常规超声检查的基础上加做超声造影检查可能对鼻咽癌患者颈部淋巴结良恶性鉴别更具有重要价值。
[Abstract]:Objective to evaluate the value of contrast-enhanced ultrasonography in the diagnosis of metastatic lymph nodes in the neck of nasopharyngeal carcinoma.Methods 119 cervical lymph nodes were collected from 30 patients with nasopharyngeal carcinoma.The target lymph nodes were examined by conventional ultrasonography and contrast-enhanced ultrasonography before the treatment of nasopharyngeal carcinoma.By analyzing the aspect ratio of lymph nodes, the structure of cutaneous medulla, the lymphatic hilum and the blood flow, the benign and malignant lymph nodes were determined by conventional ultrasonography.Contrast-enhanced ultrasonography is used to identify benign and malignant lymph nodes by observing their enhancement patterns (peripheral, central, and mixed).To analyze whether contrast-enhanced ultrasonography can improve the diagnostic rate of cervical lymph node metastasis of nasopharyngeal carcinoma.Results among the 119 lymph nodes of 30 patients with nasopharyngeal carcinoma, 35 were benign lymph nodes and 84 were malignant lymph nodes.There were 25 central enhancement modes and 4 .84 malignant lymph nodes in mixed enhancement mode. Among them, 72 were peripheral enhancement mode, 5 were central enhancement mode and 7 were mixed enhancement mode.The coincidence rate of conventional ultrasonography in the diagnosis of benign and malignant lymph nodes was 78.2 and that of contrast-enhanced ultrasonography in benign and malignant lymph nodes was 87.4. There was no significant difference between the two.The diagnostic accuracy of conventional ultrasonography combined with contrast-enhanced ultrasonography for benign and malignant cervical lymph nodes was 84.9%.Conclusion conventional ultrasonography and contrast-enhanced ultrasonography are of great value in the differential diagnosis of benign and malignant cervical lymph nodes in patients with nasopharyngeal carcinoma.On the basis of conventional ultrasonography, contrast-enhanced ultrasonography may be of great value in differentiating benign and malignant cervical lymph nodes from nasopharyngeal carcinoma (NPC) patients.
【作者单位】：广东省佛山市第一人民医院超声诊断中心;
【分类号】：R739.63;R445.1

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