金佳美,詹嘉,刁雪红,柴启亮,王海尔,陈悦.超微血管显像技术在鉴别诊断淋巴结良恶性中的应用[J].中国医学影像技术,2015,31(12):1825~1829
超微血管显像技术在鉴别诊断淋巴结良恶性中的应用
Application of superb microvascular imaging in differential diagnosis of benign and malignant lymph nodes
投稿时间:2015-02-20  修订日期:2015-11-03
DOI:10.13929/j.1003-3289.2015.12.014
中文关键词:  淋巴结  超微血管显像  超声检查  微泡
英文关键词:Lymph nodes  Superb microvascular imaging  Ultrasonography  Microbubbles
基金项目:
作者单位E-mail
金佳美 复旦大学附属华东医院超声科, 上海 200040  
詹嘉 复旦大学附属华东医院超声科, 上海 200040  
刁雪红 复旦大学附属华东医院超声科, 上海 200040  
柴启亮 复旦大学附属华东医院超声科, 上海 200040  
王海尔 复旦大学附属华东医院超声科, 上海 200040  
陈悦 复旦大学附属华东医院超声科, 上海 200040 ultrasound_chen@126.com 
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中文摘要:
      目的 探讨超微血管显像(SMI)技术对淋巴结良恶性鉴别诊断的临床应用价值。方法 回顾分析62例浅表淋巴结肿大患者的超声检查资料,并与病理结果对照,比较二维灰阶超声联合CDFI、二维灰阶超声联合SMI及CEUS鉴别诊断良性淋巴结、淋巴瘤及恶性肿瘤淋巴转移的准确率。并以CEUS为金标准,分析淋巴结内微血管分布类型。结果 62例患者共76枚浅表肿大淋巴结,其中良性淋巴结21枚,淋巴瘤32枚,恶性肿瘤淋巴结转移23枚。二维灰阶超声联合SMI与CEUS的诊断准确率均高于二维灰阶超声联合CDFI(χ2=7.91、14.04,P=0.021、0.005),而二维灰阶超声联合SMI与CEUS间差异无统计学意义(χ2=0.31,P>0.05)。CDFI及SMI与CEUS对淋巴结内微血管分布类型的一致性均较高(Kappa=0.672、0.793)。结论 SMI与CEUS对判断淋巴结内微血管分布类型具有较高的一致性,有助于提高浅表肿大淋巴结定性诊断的准确率。
英文摘要:
      Objective To assess the clinical value of superb microvascular imaging (SMI) for differential diagnosis of benign and malignant lymph nodes. Methods Ultrasonic and pathological data of 76 enlarged lymph nodes in 62 patients were retrospectively analyzed. The accuracy of two-dimensional gray-scale ultrasonography combined with CDFI, two-dimensional gray-scale ultrasonography combined with SMI and CEUS in differential diagnosis of benign lymph nodes, lymphadenomas and metastatic lymph nodes were compared. Moreover, taking CEUS results as the gold standard, the microvascular distributions in lymph nodes obtained by CDFI and SMI were studied. Results Among 76 enlarged lymph nodes, there were 21 benign lymph nodes, 32 lymphadenomas and 23 metastatic lymph nodes. The diagnostic accuracy of gray-scale ultrasonography combined with SMI and CEUS was respectively higher than that of gray-scale ultrasonography combined with CDFI (χ2=7.91, 14.04; P=0.021, 0.005). There was no statistical difference of diagnostic accuracy between gray-scale ultrasonography combined with SMI and CEUS (χ2=0.31, P>0.05). There was moderate agreement between the microvascular distributions in lymph nodes obtained by CEUS and CDFI (Kappa=0.672), while moderate agreement was also found between CEUS and SMI (Kappa=0.793). Conclusion SMI and CEUS has higher agreement for the detection of microvascular distributions. And SMI is helpful in promoting the accuracy of differential diagnosis of benign and malignant lymph nodes.
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