摘要
目的探讨超微血管成像(SMI)技术对浅表淋巴结疾病的诊断价值。方法选取84例浅表肿大淋巴结患者的超声检查资料,以病理结果为金标准,比较二维灰阶超声分别联合彩色多普勒(CDFI)、能量多普勒(PDI)、SMI及超声造影(CEUS)鉴别诊断良恶性淋巴结的准确率、敏感性、特异性。以CEUS为参照标准,比较SMI与CEUS判断浅表病变淋巴结内微血管分布类型是否具有一致性,并总结良恶性淋巴结内微血管分布类型。结果 84例患者共102枚浅表病变淋巴结病理证实:反应增生性淋巴结30枚,淋巴瘤17枚、转移性淋巴结55枚。二维灰阶超声分别联合SMI及CEUS对病变淋巴结诊断准确率均高于二维灰阶超声联合CDFI(χ2=6.34、9.97,P=0.012、0.002),亦高于二维灰阶超声联合PDI(χ2=4.17、7.27,P=0.041、0.007),而二维灰阶超声联合SMI及CEUS诊断准确率差异无统计学意义(χ2=0.48,P>0.05)。二维灰阶超声分别联合以上四种超声显像技术诊断恶性淋巴结的敏感性为77.78%、84.72%、94.44%、95.83%,特异性为73.33%、76.67%、83.33%、90.00%。SMI与CEUS判断良恶性淋巴结内微血管分布类型一致性较高(Kappa=0.792)。结论 SMI与CEUS较CDFI与PDI有更高的微血管显示率,SMI与CEUS判断良恶性淋巴结内微血管分布类型具有较高的一致性,SMI技术有助于提高浅表病变淋巴结定性诊断的准确率。
Objective To investigate the diagnostic value of superb microvascular imaging(SMI) for superficial lymph node disease. Methods A retrospective analysis of ultrasound examination data of 84 patients with superficial lymph nodes was condusted. The pathological results were taken as the gold standard to compare the accuracy, sensitivity and specificity of two-dimensional gray-scale ultrasound combined withcolor Doppler(CDFI), power Doppler(PDI), SMI and contrast-enhanced ultrasound(CEUS) in differential diagnosis of benign and malignant lymph nodes. CEUS was used as the reference standard to compare whether there was consistency between the distribution of microvessels in superficial lesions lymph nodes by SMI and CEUS,and to summarize the type of microvascular distribution in benign and malignant lymph nodes. Results A total of 102 superficial lymph nodes in 84 patients were confirmed by pathology, including 30 hyperplastic lymph nodes and 17 lymphomas and 55 metastatic lymph node. The diseased lymph nodes diagnostic accuracy of two-dimensional gray-scale ultrasound combined with SMI and CEUS were higher than that of two-dimensional gray-scale combined with CDFI(χ2= 6.34, 9.97, P=0.012, 0.002), also higher than the two-dimensional gray scale ultrasound combined with PDI(χ2=4.17, 7.27, P=0.041, 0.007). There was no significant difference in diagnostic accuracy between two-dimensional gray-scale ultrasound combined with SMI and CEUS(χ2=0.48, P=0.489). The sensitivity of two-dimensional gray-scale ultrasound combined with the above four ultrasound imaging techniques in the diagnosis of malignant lymph nodes were 77.78%, 84.72%, 94.44% and 95.83%. The specificity was 73.33%, 76.67%, 83.33%, 90.00%. The consistency of microvascular distribution in benign and malignant lymph nodes was higher by SMI and CEUS(Kappa=0.792). Conclusion SMI and CEUS have higher microvascular display rate than CDFI and PDI. SMI and CEUS have high consistency in judging the distribution of microvessels in benign and malignant lymph nodes, SM
作者
张春征
王芳
红华
ZHANG Chunzheng;WANG Fang;HONG Hua(Department of Functional,Affiliated Hospitl of Hebei University of Engineering,Handan 056002,P.R.China;Department of Ultrasound,Inner Mongolia People's Hospital,Inner Mongolia Huhhot 010017,P.R,China)
出处
《医学影像学杂志》
2020年第10期1829-1833,共5页
Journal of Medical Imaging
基金
内蒙古自治区自然科学基金项目(编号:2016MS0886)。
关键词
淋巴结
超微血管成像
超声检查
Lymph nodes
Superb microvascular imaging
Ultrasonography
