超声造影在颈部淋巴结结核中的诊断效能研究

摘 要] 目的 探讨颈部淋巴结结核超声造影特征性增强模式的诊断效能。方法 收集病理或实验室确诊的颈部淋巴结肿大病例226例，分析淋巴结结核的超声造影特征性增强模式在结核性与非结核性淋巴结病变上的差异，并统计分析其诊断效能。结果 颈部淋巴结结核在超声造影上常表现为淋巴结内部不均匀增强和淋巴结周边环形增强。在确诊的104例颈部淋巴结结核中，85例表现为内部不均匀增强（与非结核组比较，P < 0.01），其诊断敏感性为81.73%，特异性79.51%；有89例表现为淋巴结周围环形增强（与非结核组比较，P < 0.01），其诊断敏感性为85.58%，特异性87.70%；76例既有内部不均匀增强又有周围环形增强（与非结核组比较，P < 0.01），其诊断敏感性为73.08%，特异性94.44%。结论 超声造影能较好地评估淋巴结内部的增生与坏死情况；淋巴结内部不均匀增强和淋巴结周围环形增强是颈部淋巴结结核的超声造影特征性征象，可为其诊断和鉴别诊断提供帮助。

The role of Contrast-enhanced Ultrasound in the Diagnosis of Cervical Tuberculous Lymphadenitis

Abstrast] Objectives To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) for cervical tuberculous lymphadenitis (CTL). Methods 226 patients with cervical lymphadenectasis and pathological or laboratory confirmation who underwent CEUS examination were retrospectively enrolled. The enhancement patterns of the lymph nodes in CEUS were analyzed. Results 104 cases were confirmed as CTL, while 122 cases were non-tuberculous. More CTL cases showed internal heterogeneous enhancement of the lymph nodes than the non-tuberculous cases 81.73% (85/104) vs 20.49% (25/122), P<0.01]. The sensitivity was 81.73%, and the specificity was 79.51%. In addition, more of the CTL cases showed peripheral rim-like enhancement than the non-tuberculous cases 85.58% (89/104) vs 12.30% (15/122), P<0.01]. The sensitivity was 85.58%, and the specificity was 87.70%. 76 CTL cases (73.08%) showed both features, while only 8 non-tuberculous cases (6.56%) did so (P<0.01). The sensitivity was 73.08%, the specificity was up to 93.44%. Conclusions CEUS well assessed the necrosis and hyperplasia within lymph node lesions. Internal heterogeneous enhancement and peripheral rim-like enhancement of lymph nodes are the characteristics of CTL in CEUS.