摘要
目的 探讨颈部淋巴结结核超声造影(CEUS)声像特征及其诊断价值。方法 回顾性分析青海省中医院2021年1月—2023年12月期间收治的肺结核继发颈部淋巴结肿大患者146例,按照病理结果及结核杆菌微生物学检测结果分为结核组(61例)和非结核组(85例)。全部病例均进行常规超声CEUS检查及病理检测。分析颈部淋巴结结核患者的CEUS声像特征性表现,比较常规超声、CEUS对颈部淋巴结结核的诊断价值。结果 结核组淋巴结内蜂窝样增强、边缘环形增强等CEUT征象明显高于非结核组(P<0.05),且结核组淋巴结最大径≤20 mm与>20 mm的CEUS表现特征对比有统计学差异(P<0.05)。CEUS诊断的灵敏度、准确度均明显高于常规超声(P<0.05),但二者特异度差异无统计学意义(P>0.05);淋巴结坏死CEUS检出率明显高于常规超声(P<0.05)。颈部淋巴结结核患者增强模式表现为多样性,以不均匀增强为主,表现为淋巴结内蜂窝样增强、高增强边缘或二者并存等CEUS特征性表现;颈部淋巴结结核最大径≤20 mm的CEUS以高增强边缘为主,>20mm的CEUS以淋巴结内蜂窝样增强为主。结论 与非结核相比,颈部淋巴结结核的CEUS特征性表现可客观反映其增强、坏死情况。CEUS诊断颈部淋巴结结核的灵敏度、准确度高于常规超声。
Objective To investigate the performance of contrast-enhanced ultrasound(CEUS)in pulmonary tuberculosis complicated with cervical lymph node tuberculosis,and to compare with conventional ultrasound,and to analyze the diagnostic value of CEUS.Methods A total of 146 patients with cervical lymph node enlargement secondary to pulmonary tuberculosis admitted to Qinghai Provincial Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were selected and divided into tuberculosis group(61 cases)and non-tuberculosis group(85 cases)according to the pathological results and the results of mycobacterium tuberculosis microbiological detection.All cases were confirmed by pathological results after routine ultrasound and CEUS examination.Analyze the CEUS characteristics of patients with cervical lymph node tuberculosis,and compare the value of conventional ultrasound.Results Compared with the non-tuberculosis group,the CEUT signs such as honeycomb enhancement and edge ring enhancement in the lymph nodes of the tuberculosis group were significantly higher,and the CEUS features of the lymph nodes in the tuberculosis group with the maximum diameter≤20 mm and>20 mm were more significant(P<0.05).Compared with conventional ultrasound,the sensitivity and accuracy of CEUS were significantly higher(P<0.05),but there was no significant difference in specificity between them(P>0.05).The necrosis rate of lymph nodes detected by CEUS was also significantly higher than that by conventional ultrasound(P<0.05).The enhancement patterns of patients with cervical lymph node tuberculosis showed diversity,mainly uneven enhancement,which was characterized by CEUS characteristics such as honeycomb enhancement,edge ring enhancement or both in lymph nodes.CEUS with the maximum diameter of cervical lymph node tuberculosis≤20 mm was mainly edge ring enhancement mode,and CEUS with the maximum diameter of cervical lymph node tuberculosis>20 mm was mainly intralymph node honeycomb enhancement mode.Conclusion Compared with non-tuberc
作者
张文
刘晓宇
温智峰
冶骏
叶俊
王琰
ZHANG Wen;LIU Xiaoyu;WEN Zhifeng;YE Jun;YE Jun;WANG Yan(Ultrasound Medicine Department,Qinghai Provincial Traditional Chinese Medicine Hospital,Xining Qinghai 810001,China)
出处
《中国急救复苏与灾害医学杂志》
2024年第8期1060-1062,1087,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
2021年青海省卫健委指导性课题项目(编号:2021-wjzdx-100)。
关键词
肺结核
颈部淋巴结结核
超声造影
常规超声
诊断价值
Pulmonary tuberculosis
Cervical lymph node tuberculosis
Contrast-enhanced ultrasound
Conventional ultrasound
Diagnostic value
