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2025-06-14 星期六
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张俊鹏,夏燕飞,韩雪,种静,史琳.应变弹性成像与声触诊组织成像定量技术鉴别诊断颈部良、恶性淋巴结[J].中国医学影像技术,2022,38(1):137~140

应变弹性成像与声触诊组织成像定量技术鉴别诊断颈部良、恶性淋巴结

Strain elastography and virtual touch tissue imaging quantification technique for differential diagnosis of benign and malignant cervical lymph nodes

投稿时间：2020-05-13 修订日期：2021-10-13

DOI：10.13929/j.issn.1003-3289.2022.01.033

中文关键词: 颈部淋巴结超声检查弹性成像技术

英文关键词:neck lymph nodes ultrasonography elasticity imaging techniques

基金项目:

作者	单位	E-mail
张俊鹏	山东第一医科大学附属省立医院超声医学科，山东济南 250021
夏燕飞	山东第一医科大学附属省立医院超声医学科，山东济南 250021
韩雪	山东第一医科大学附属省立医院超声医学科，山东济南 250021
种静	青岛大学附属医院超声科，山东青岛 266003
史琳	山东第一医科大学附属省立医院超声医学科，山东济南 250021	747778624@qq.com

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中文摘要:

目的观察应变弹性成像(SE)与声触诊组织成像定量(VTIQ)技术鉴别诊断颈部良、恶性淋巴结的价值。方法纳入106例接受颈部超声及颈部淋巴结组织病理学检查患者、共123个颈部异常淋巴结，根据病理结果将其分为良性组(n=34)和恶性组(n=89)。采用SE检测异常淋巴结所占面积(AREA%)，以VTIQ技术检测淋巴结剪切波速度(SWV)，比较2组淋巴结超声特征的差异；以病理结果作为金标准，观察SE与VTIQ技术鉴别诊断良、恶性淋巴结的效能。结果恶性组淋巴结门消失、纵横比(L/S)＜2、血流阻力指数(RI)＞0.7、AREA%＞45.23%及SWV＞3.05 m/s占比均大于良性组(P均＜0.05)。以AREA%=45.23%为最佳截断值，鉴别诊断良、恶性淋巴结的敏感度为84.27%，特异度为70.59%，曲线下面积(AUC)为0.74；以SWV=3.05 m/s为最佳截断值，敏感度为88.76%，特异度为73.53%，AUC为0.84，显著大于AREA%的AUC(Z=2.83，P＜0.01)。SE鉴别诊断良、恶性淋巴结的敏感度和特异度分别为76.13%和68.00%，VTIQ技术的诊断敏感度和特异度分别为84.55%和73.53%，与SE差异均无统计学意义(χ²=0.27，P=0.60；χ²=0.25，P=0.62)。结论 SE及VTIQ技术均可定量评估颈部淋巴结硬度以鉴别其良恶性；VTIQ的诊断效能较高，SWV大于3.05 m/s提示为恶性淋巴结

英文摘要:

Objective To observe the value of strain elastography (SE) and virtual touch tissue imaging quantification (VTIQ) technique for differential diagnosis of benign and malignant cervical lymph nodes.Methods Totally 123 abnormal cervical lymph nodes in 106 patients who underwent neck ultrasonography and cervical lymph node histopathology were enrolled. The patients were divided into benign group (n=34) and malignant group (n=89) according to pathological results. The area proportion of abnormal lymph nodes (AREA%) was detected with SE, and the shear wave velocity (SWV) was measured with VTIQ. The ultrasonic characteristics of cervical lymph nodes were compared between groups. Taken pathological results as gold standards, the efficacy of SE and VTIQ for differential diagnosis of benign and malignant cervical lymph nodes was observed.Results The proportion of lymph node hilar disappearance, long diameter/short diameter (L/S) < 2, resistance index (RI) > 0.7, AREA% > 45.23% and SWV > 3.05 m/s in malignant group were significantly higher than those in benign group (all P < 0.05). Taken AREA%=45.23% as the best cutoff value, the sensitivity and specificity for differential diagnosing benign and malignant lymph nodes was 84.27% and 70.59%, respectively, and the area under the curve (AUC) was 0.74. Taken SWV=3.05 m/s as the best cutoff value, the sensitivity was 88.76%, the specificity was 73.53%, and the AUC was 0.84, which was significantly higher than that of AREA% (Z=2.83, P < 0.01). The sensitivity and specificity of SE for differential diagnosis of benign and malignant cervical lymph nodes was 76.13% and 68.00%, respectively, and of VTIQ was 84.55% and 73.53%, respectively. No significant difference of sensitivity and specificity was found between SE and VTIQ (χ²=0.27, P=0.60; χ²=0.25, P=0.62).Conclusion Both SE and VTIQ could quantitatively evaluate the hardness of cervical lymph nodes for differential diagnosis of benign and malignant lymph nodes. The diagnostic value of VTIQ was higher, and SWV > 3.05 m/s indicated malignant lymph nodes.

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