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目的研究彩色多普勒超声对浅表淋巴结结核患者的鉴别诊断价值。方法选择自2013年5月-2015年5月本院收治的54例疑似浅表淋巴结结核的患者作为研究对象,分别采用常规CT和彩色多普勒诊断,两组参与检测的医护人员彼此不知道对方的检测结果,然后对患者的相关部位进行穿刺活检,进行细胞学或病理分析,确定最终结果。比较常规CT和彩色多普勒诊断对浅表淋巴结结核的诊断灵敏度、特异性,以及与最终结果的诊断符合率。结果彩色多普勒超声检查阳性48例,阴性6例,其中有1例误诊。CT检查阳性46例,2例误诊;阴性8例,误诊5例;与病理活检结果相比,虽然两种方法对于浅表淋巴结结核的灵敏度、特异度差异不具有统计学意义(P>0.05),但彩色多普勒超声检查结果与最终病理活检结果的符合率更高,差异具有统计学意义(P<0.05)。浅表淋巴结结核依据不同病理改变可分为淋巴结炎症型、干酪坏死型、液化脓肿型和愈合期钙化型4种类型,具体彩色多普勒超声影像表现不同。结论彩色多普勒超声检测对于浅表淋巴结结核患者的诊断价值极高,灵敏度、特异性以及准确度均显著高于常规CT检查,对患者身体无害,安全性好,实用性强,值得临床推荐。
Objective To study the differential diagnosis value of color Doppler ultrasonography in patients with superficial lymph node tuberculosis. Methods From May 2013 to May 2015, 54 patients with suspected superficial lymph node tuberculosis in our hospital were selected as the study subjects. The patients were diagnosed by conventional CT and color Doppler, respectively. The two groups of medical staff who participated in the test did not know each other Each other’s test results, and then the patient’s relevant parts of the biopsy, cytological or pathological analysis to determine the final result. Diagnostic sensitivity, specificity, and diagnostic accuracy of the final results were compared between routine CT and color Doppler imaging in diagnosing superficial lymph node tuberculosis. Results Color Doppler ultrasound was positive in 48 cases, 6 cases were negative, of which 1 case was misdiagnosed. CT was positive in 46 cases, misdiagnosed in 2 cases, negative in 8 cases and misdiagnosed in 5 cases. Compared with pathological biopsy results, there was no significant difference in sensitivity and specificity between the two methods for superficial lymph node tuberculosis (P> 0.05) , But the coincidence rate of color Doppler ultrasound examination and final pathological biopsy was higher, the difference was statistically significant (P <0.05). According to different pathological changes, superficial lymph node tuberculosis can be divided into four types: lymphadenitis type, cheese necrosis type, liquefaction abscess type and healing type calcification type. The specific color Doppler ultrasound images have different manifestations. Conclusion The color Doppler ultrasonography is of great value in the diagnosis of superficial lymph node tuberculosis patients. The sensitivity, specificity and accuracy are significantly higher than those of routine CT examination. It is harmless to the patient, safe and practical, and worthy of clinical application recommend.