彩色多普勒超声对浅表肿大淋巴结良恶性鉴别诊断价值.doc

彩色多普勒超声对浅表肿大淋巴结良恶性鉴别诊断价值 　【摘要】 目的 探讨超声诊断浅表淋巴结良恶性病变的声像图特征与临床实用价值。方法 对46例因浅表淋巴结肿大就诊的患者，应用彩色多普勒超声观察120个浅表淋巴结的纵径/横径(L/S)值、内部回声、CDFI及PWD频谱特征。结果 良、恶性肿大淋巴结的L/S值分别为2.09±0.22、1.56±0.27。淋巴门处髓质主干动脉收缩期峰值血流速度(Vmax)分别为(19.52±13.36)cm/s、(27.56±15.27)cm/s；舒张期末血流速度(Vmin)分别为(7.98±4.48)cm/s、(6.35±3.86)cm/s。阻力指数(RI)分别为0.59±0.13、0.77±0.11。四项指标中L/S值及RI差异有非常显著性(P＜0.001)。良性肿大淋巴结内部回声多呈髓质增宽、增强，皮质相对变窄，恶性肿大淋巴结内部回声则反之。CDFI示良性肿大淋巴结内血流较丰富、规则，多呈树枝状分布；而恶性肿大淋巴结内血流则多呈不规则紊乱血流信号。结论 通过对淋巴结超声测量的L/S值分析，结合淋巴结内部回声、CDFI和频谱分析，对淋巴结的良恶性鉴别具有实用价值，可作为淋巴结诊断的首选方法，并为进一步穿刺活检提供依据。 【关键词】 超声 浅表淋巴结 彩色多普勒 脉冲多普勒 性质鉴别 【Abstract】 Objective To discuss the ultrasound differentiation value of benign and malignant superficial tumescent lymph nodes.Methods The L/S ratio，interior echo，CDFI and PWD frequency spectrum feature of the superficial lymph nodes in 46 patients’120 nodes were studied with color Doppler ultrasound.Results The L/S ratio of the two groups including benign and malignant superficial lymph nodes were 2.09±0.22，1.56±0.27，medullary truncus arteriosus Vmax were 19.52±13.36cm/s，27.56±15.27cm/s，Vmin were 7.98±4.48cm/s，6.35±386cm/s and RI were 0.59±0.13，0.77±0.11 respectively.It has obvious differences of the two quotas of the L/S ratio and RI (P＜0105).Interior echo of benign tumescent lymph nodes displayed wider and brighter of the medulla and narrow of the cortices，but the malignant tumescent lymph nodes were on the contrary.CDFI showed the blood flow of the most benign tumescent lymph nodes displayed more abundant and regular，and the blood flow of most malignant lymph nodes displayed disorder and irregular.Conclusion The L/S ratio，interior echo，CDFI and PWD frequency spectrum feature identification and diagnosis of the superficial benign and malignant lymph nodes has its edges possibly being the first trial method. 【Key words】 ultrasound superficial lymph nodes color Doppler flow imaging pulsed-wave Doppler quality identification 浅表淋巴结是指位于体表深筋膜层、距离皮肤3.0cm以内的淋巴结群。淋巴结病变往往是局部和全身疾病的反应。浅表淋巴结(头颈、腋窝、锁骨上窝及腹股沟区)是诊