摘要
目的研究鼻咽癌颈部转移性淋巴结的超声造影特征并分析其时间一强度曲线特点。方法对32例鼻咽癌患者的41个颈部转移性淋巴结进行实时超声造影,观察淋巴结的造影剂灌注特征,并行时间-强度曲线分析。结果41个颈部转移性淋巴结中24.4%(10/41)表现为均匀增强型,56.1%(23/41)表现为不均匀增强型,19.5%(8/41)表现为微弱增强型。共有20个淋巴结出现内部液化坏死,占48.8%(20/41)。绝大多数呈边缘型血流信号,占92.7%(38/41),少数呈混合型血流信号,占7.3%(3/41),两者差异有统计学意义(P〈0.01)。造影曲线表现为上升支陡直,下降支相对缓慢,呈快上慢下的灌注过程,平均到达时间为(7.2±2.5)S,平均达峰时间为(7.6±2.3)S,峰值强度平均(9.5±3.3)dB,峰值到60S曲线下面积平均为(203.4±45.7)dB·s,washin曲线斜率平均1.2±0.5。对于包膜有、无受侵的淋巴结,其在峰值强度、峰值到60S曲线下面积等方面差异有统计学意义(P〈0.05);而在造影剂到达时间、达峰时间、washin曲线斜率等方面差异无统计学意义(P〉0.05)。结论鼻咽癌颈部转移性淋巴结有其特殊的造影特征和时间-强度曲线特点,不仅有利于定性诊断鼻咽癌颈部转移性淋巴结,还可为鼻咽癌治疗和预后提供更多的信息。
Objective To study the character of cervical lymph nodes metastasis in nasopharyngeal carcinoma(NPC) by contrast enhanced ultrasonography(CEUS) and time intensity curve. Methods Forty one lymph nodes of metastasis from 32 patients were studied by CEUS. The enhancement of echogenicity was evaluated,and the time-intensity curve was analyzed. Results Of the 41 lymph nodes examined, 10 (24.4%) showed intense homogeneous enhancement by CEUS, 23 (56.1%) showed inhomogeneous enhancement and 8 ( 19.5 % ) showed scarce intranodal enhancement. There were 20 (48.8 % ) lymph nodes showed necrosis. Most of the lymph nodes(92.7%) showed peripheral type blood flow,3(7. 3)% showed mixed type blood flow. There were significant differences in them( P 〈0. 0l ). The time-intensity curve displayed steeply in upslope,and gently in decent. The arrival time(AT),time to peak(TTP),peak intensJty (PI),areaand gradient were (7.2±2.5)s,(7.6±2.3)s,(9.5 ±3.3)dB,(203.4±45.7)dB. s,1.2±0.5 respectively. Between the lymph nodes with envelope infringed and not, there were significant differences in PI and area, while there were not significant differences in AT, TTP and gradient. Conclusions The metastasis cervical lymph nodes of NPC had specific character by CEUS and time intensity curve. In this way,it may help us to diagnosis cervical lymph nodes metastasis of NPC, and provide more information for the therapy and prognosis judgement.
出处
《中华超声影像学杂志》
CSCD
北大核心
2009年第6期510-513,共4页
Chinese Journal of Ultrasonography
基金
浙江省医药卫生科学研究基金(2007B020)
关键词
超声检查
微气泡
鼻咽肿瘤
淋巴转移
Ultrasonography
Microbubbles
Nasopharyngeai neoplasms
Lymphatic metastasis