摘要
目的探讨三维超声鉴别诊断颈部不典型良恶性淋巴结的价值。方法收集98例单发颈部肿大的淋巴结患者的资料,依二维诊断标准将淋巴结分为良性组(反应性增生)和恶性组(淋巴瘤、转移性淋巴结),行三维超声检查,运用VOCAL软件测量淋巴结髓质容积与淋巴结整体容积,计算容积比(Vm/Vt),观察淋巴结三维髓质形态及三维血流模式。结果良性与恶性组淋巴结的Vm/Vt差异有统计学意义(P<0.01);Vm/Vt、三维血流模式、三维髓质形态的ROC曲线下面积(AUC)分别为0.79、0.96、0.87;取0.13为评判淋巴结良恶性的最佳界值,敏感度80.40%,特异度67.30%,超声征象与病理表现吻合程度的Kappa值分别为0.47、0.92、0.74。结论 Vm/Vt、三维血流模式、三维髓质形态对鉴别颈部淋巴结良恶性病变具有重要价值。
Objective To observe the value of three-dimensional ultrasound in differential diagnosis of benign and malignant atypical cervical lymph nodes.Methods Totally 98 single cervical enlarged lymph nodes in 98 patients were divided into benign（reactive hyperplasia） and malignant groups（lymphoma,metastatic lymph nodes） according to two-dimensional ultrasound.The lymph nodes were detected with two-dimensional color Doppler firstly,and then with three-dimensional ultrasound.The medulla of lymph nodes volume and total volume were measured by VOCAL software with three-dimensional ultrasound,the medulla volume of lymph nodes/total volume of lymph nodes（Vm/Vt） was calculated,while three-dimensional image were reconstructed to observe the medulla morphology and flow model.Results Significant statistical difference of Vm/Vt was found between benign and malignant groups（P0.01）.The area under the curve（AUC） of Vm/Vt,medulla morphology and flow model was 0.79,0.96,0.87,respectively.When the best cutoff of the evaluation of benign and malignant lymph nodes was set at 0.13,the sensitivity was 80.40%,and the specificity was 67.30%.The Kappa values of the Vm/Vt,medulla flow model and morphology was 0.47,0.92,0.74,respectively.Conclusion Vm/Vt,three-dimensional morphology flow model and three-dimensional medulla morphology have good value in differential diagnosis of benign and malignant atypical cervical lymphadenopathy.
出处
《中国医学影像技术》
CSCD
北大核心
2011年第10期2002-2005,共4页
Chinese Journal of Medical Imaging Technology
关键词
超声检查
淋巴结
颈部
容积
Ultrasonography
Lymph nodes
Cervical
Volume
