弹性成像技术在浅表淋巴结良、恶性鉴别诊断中的临床应用

目的探讨超声弹性成像(UE)在浅表淋巴结良、恶性鉴别诊断中的临床应用价值。方法选取2013年1⁷月在新疆医科大学第一附属医院住院就诊的88例淋巴结肿大患者,随机选取88个肿大的浅表淋巴结,分别采用B型超声(B超)、彩色多普勒血流成像(CDFI)和UE进行检测,将结果分别与病理诊断结果比较,对UE、B超和CDFI诊断浅表淋巴结良恶性的灵敏度、特异度和准确率进行统计分析。UE检测采用弹性评分法评估。结果 B超对良、恶性淋巴结的诊断灵敏度、特异度和准确率分别为68.4%、81.6%和82.9%;CDFI的灵敏度、特异度和准确率分别为76.0%、78.9%和78.9%;UE的灵敏度、特异度和准确率分别为96.0%、84.2%和90.9%。与B超相比,UE法鉴别诊断良、恶性淋巴结的灵敏度更高,差异有统计学意义(P<0.05);B超、CDFI和UE与病理检查结果的吻合系数分别为0.580、0.619和0.723(均P<0.05)。UE与病理检查结果的吻合度高于常规超声。结论 UE在良、恶性浅表淋巴结的鉴别诊断中的灵敏度较B超、CDFI高,UE在单独诊断浅表淋巴结良、恶性上具有一定的临床应用价值。

Clinical Application of Ultrasound Elastography in the Diagnosis of Malignant and Benign Superficial Lymph Nodes

Objective To investigate the clinic value of uhrasound elastography （U E） in the diagnosis of malignant and benign superficial lymph nodes.Methods Randomly selected 88 lymph nodes from the 88 cases of patients with lymphadenectasis admitted to the First Affiliated Hospital of Xinjiang Medical University from Jan.to Jul.2013,examined them by type B uhrasonic,color Doppler flow imaging （CDFI） and UE respectively.Compared the results under the above three methods with the results of pathologic diagnosis,and analyzed the sensitivity,specificity and accuracy of the three methods in the diagnosis of malignant and benign superficial lymph nodes.UE detection was evaluated by elastography score system.Results The sensitivity,specificity and accuracy of type-B ultrasonic were 68.4%,81.6% and 82.9% ; the sensitivity,specificity and accuracy of CDFI were 76.0%,78.9% and 78.9% ; the same indexes of UE were 96.0%,84.2 % and 90.9% respectively.The results showed that U E had higher sensitivity than type-B uhrasonic,of which the difference was statistically significant（P 〈 0.05）.Results of the consistency analysis between pathologic diagnosis and the type-B ultrasonic,CDFI,UE were 0.580,0.619 and 0.723（all P 〈 0.05）,which showed UE had the highest matching degree with pathologic diagnosis.Conclusion UE has the highest sensitivity in the diagnosis of malignant and benign lymph nodes comparing with the conventional uhrasound and CDFI,the difference of specificity and accuracy among the three methods has no statistical significance.Therefore,UE has relatively higher clinical value in the single diagnosis of malignant and benign lymph nodes.