颈部淋巴结肿大的超声影像参数分析

【目的】评价各种超声影像学指标在颈部肿大淋巴结良恶性诊断中的价值。【方法】回顾性分析经病理证实的192枚颈部肿大淋巴结的超声影像学表现。超声影像学指标包括：淋巴结的长径（L）与短径（S）的比例（L／S〉、髓质与门部回声、皮质厚度、淋巴结内血流形态、动脉血流阻力指数（RI）等。【结果】L／S〈2诊断恶性淋巴结的敏感性为81％，特异性为69．2％，髓质回声变窄或消失诊断恶性淋巴结的敏感性为92．2％，特异性为73．1％，皮质偏心性增厚诊断恶性淋巴结的敏感性为79．2％，特异性为73．1％，血管类型诊断恶性淋巴结的敏感性为83．7％，特异性为88．5％，RI≥0．7诊断恶性淋巴结的敏感性为75．5％，特异性为68．8％。【结论】髓质回声变窄或消失、血管类型等参数对恶性淋巴结的诊断具有重要价值。

Multiparameter Analysis of Cervical Lymphadenopathy by Ultrasonography

[Objective] To evaluate the value of various sonographic parameters for the diagnosis of malig- nant cervical lymphadenopathy. [Methods] The immage manifestations of 192 cervical lymph nodes （90 metastases, 76 lymphoma, 11 tuberculosis, 15 reactive） identified by pathology were reviewed. All patients had cer- vical lymphadenectasis. Sonographic parameters including the ratio of long to short axis （L/S）, medulla and hilus echo, cortical thickness, patterns of blood flow in lymph node and vascular resistance index（RI）were analyzed. [Results] The sensitivity and specificity were 81.3% and 69.2% for L/S〈2,92.2% and 73.1% for the loss or narrow of medulla echo, 79. 2% and 73. 1% for the eccentric cortical thickening , 83. 7% and 88.5% for the vascular patterns , 75.5% and 68.8% for RI≥7, respectively. [Conclusion] The parameters such as the loss or narrow of medulla echo and vascular patterns have the highest sensitivity and specificity and can be considered as the major ultrasound criteria for the diagnosis of malignant lymph node.