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目的分析颈部淋巴结病变的超声造影特点并评价其诊断价值。方法对83例(138枚)颈部肿大淋巴结患者进行超声造影检查,观察淋巴结的强化模式特征并分析其时间-强度曲线。结果 138枚淋巴结中结核23枚,非特异度淋巴结炎38枚,淋巴瘤29枚,转移癌48枚。超声造影结果显示非特异度淋巴结炎主要表现为通过淋巴门均匀灌注型(30/38,78.9%)(P<0.01);淋巴瘤主要表现为非单一通过淋巴门均匀灌注型(20/29,69.0%)(P<0.01);结核及转移性淋巴结则主要表现为不均匀灌注(14/23,60.9%;25/48,52.1%)(P<0.01)。超声造影时间-强度曲线定量分析,非特异度炎性组及淋巴瘤组的上升时间、达峰时间均短于结核组(P<0.01);转移组的上升时间短于结核组(P<0.008)。应用超声造影模式诊断颈部良恶性淋巴结的灵敏度为76.6%、特异度为65.3%。结论超声造影技术能反映肿大淋巴结的灌注模式及特点,对诊断有一定价值。
Objective To analyze the characteristics of cervical lymphadenopathy and evaluate its diagnostic value. Methods Totally 83 patients (138) with enlarged neck lymph nodes underwent contrast-enhanced ultrasonography to observe the enhancement pattern of lymph nodes and analyze the time-intensity curve. Results Thirteen 138 tuberculosis tuberculosis, 38 non-specific lymphadenitis, 29 lymphoma and 48 metastatic cancer. The results of CEUS showed that nonspecific lymphadenitis mainly manifested as uniform perfusion through lymphatic (30/38, 78.9%) (P <0.01). Lymphoma mainly manifested as non-monopolar lymphatic perfusion (20/29, 69.0%, respectively) (P <0.01). Tuberculosis and metastatic lymph nodes mainly showed uneven perfusion (14/23, 60.9%; 25/48, 52.1%) (P <0.01). The time-intensity curve of quantitative contrast-enhanced ultrasound, nonspecific inflammatory group and lymphoma group had shorter rise time and peak time than tuberculosis group (P <0.01), and the rise time of metastasis group was shorter than that of tuberculosis group (P <0.008 ). The diagnostic sensitivity of benign and malignant cervical neoplasms was 76.6% and the specificity was 65.3%. Conclusion Contrast-enhanced ultrasound can reflect the perfusion patterns and features of enlarged lymph nodes, and has some value in diagnosis.