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[目的]探讨鼻咽癌患者颈部转移性淋巴结的超声特征和诊断标准。[方法]鼻咽癌初诊患者197例治疗前行颈部超声检查,并对随机选取的淋巴结行细针穿刺细胞学检查共计368枚,将细胞学结果与相应淋巴结超声特征进行对照分析。[结果]转移性淋巴结283枚(占穿刺淋巴结76.9%),绝大多数位于Ⅱ区、Ⅲ区和Ⅴ区(分别占42.8%、20.1%、21.9%),99.3%的淋巴结最小横径大于5mm,80.9%为类圆形(SA/LA>0.5),多不显示高回声门部或呈偏心性,少数有淋巴结内液化坏死(18.0%),40.6%有包膜受侵表现,大多数血流丰富(71.0%),且阻力指数(RI)大于0.6。[结论]鼻咽癌颈部转移性淋巴结有其特定的超声特征,建议鼻咽癌颈部淋巴结转移的超声诊断标准为SA/LA>0.5或RI>0.6,并且最小横径>5mm。
[Objective] To investigate the ultrasound features and diagnostic criteria of cervical metastatic lymph nodes in patients with nasopharyngeal carcinoma. [Method] 197 cases of newly diagnosed nasopharyngeal carcinoma patients underwent neck ultrasonography before the treatment. A total of 368 cytological examinations were performed on the randomly selected lymph nodes. The cytological results were compared with the corresponding lymph node ultrasonography. [Results] The number of metastatic lymph nodes was 283 (accounting for 76.9% of the punctate lymph nodes), the vast majority of them located in Zone Ⅱ, Ⅲ and Ⅴ (42.8%, 20.1% and 21.9% respectively). The smallest diameter of 99.3% lymph nodes was larger than 5mm , 80.9% were sagittal (SA / LA> 0.5). Most of them did not show hyperechoic door or were eccentric, a few had liquefaction necrosis in lymph nodes (18.0%), 40.6% The stream is rich (71.0%) and the resistance index (RI) is greater than 0.6. [Conclusion] The cervical lymph node metastasis of nasopharyngeal carcinoma has its special ultrasonic characteristics. It is suggested that the diagnostic criteria of cervical lymph node metastasis of nasopharyngeal carcinoma is SA / LA> 0.5 or RI> 0.6, and the minimum diameter> 5mm.