Application value of high-frequency ultrasound and its image features in the diagnosis of superficial lymph node lesions
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摘要:
目的探究高频超声及其图像特征在浅表淋巴结病变诊断中的应用价值。 方法回顾2019年6月~2021年2月于我院收治的106例浅表淋巴结病变患者的临床资料，患者均进行高频超声检查，以病理检查结果作为金标准。将患者根据病理诊断良恶性结果进行分组，比较良性组（n=45）、恶性组（n=61）患者高频超声图像特征差异，包括：淋巴结长径（L）/短径（S）、血管化评分（VS）、淋巴结最大血流速度（Vmax）、最小流速（Vmin）、阻力指数（RI）。比较高频超声与病理检查结果差异，使用ROC曲线分析高频超声评估浅表淋巴结病变的价值。 结果良性组、恶性组患者淋巴结L/S < 2、VS、淋巴结Vmax、RI差异均有统计学意义（P < 0.05）。高频超声诊断浅表淋巴结病变的准确率为85.85%，敏感度为90.16%，特异性为80.00%，阳性预测值为85.94%，阴性预测值为85.71%。ROC曲线结果显示，淋巴结Vmax、RI诊断价值均较高（P < 0.05）。 结论高频超声评估浅表淋巴结病变的价值较高，可区分良恶性浅表淋巴结病变。 Abstract:ObjectiveTo explore the application value of high-frequency ultrasound and its image features in the diagnosis of superficial lymph node lesions. MethodsThe clinical data of 106 patients with superficial lymph node lesions admitted to the hospital between June 2019 and February 2021 were reviewed. All patients underwent high-frequency ultrasound examination, and pathological examination Results were used as the gold standard. The patients were grouped based on the pathological diagnosis of benign and malignant results. The features of high-frequency ultrasound images [lymph node long diameter (L)/short diameter (S), vascularization score (VS), lymph node maximum blood flow velocity (Vmax), minimum flow velocity (Vmin), resistance index (RI)] were compared between benign group (n=45) and malignant group (n=61). The differences in Results of high-frequency ultrasound and pathological examination were compared. ROC curve was used to analyze the value of high-frequency ultrasound in evaluating superficial lymph node lesions. ResultsThe difference in lymph node L/S < 2, VS, lymph node Vmax, and RI between benign group and malignant group were significant(P < 0.05). The accuracy rate, sensitivity, specificity, positive predictive value and negative predictive value of high-frequency ultrasound in the diagnosis of superficial lymph node lesions were 85.85%, 90.16%, 80.00%, 85.94% and 85.71%. ROC curve Results showed that the diagnostic value of lymph node Vmax and RI were both high (P < 0.05). ConclusionHigh-frequency ultrasound is of higher value in evaluating superficial lymph node lesions, and can distinguish benign and malignant superficial lymph node lesions. -
Key words:
- high-frequency ultrasound /
- lymph nodes /
- superficial lymph nodes /
- lesions /
- diagnosis
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图 1 淋巴结高频超声表现
A~C：左侧颈部探及多个淋巴结回声，较大者大小约42 mm×23 mm，皮髓质分界不清，内可见片状无回声区，其内可见点状血流信号，较大者包绕部分左侧颈动脉及锁骨下动脉；D~E：左肘部及左腋窝探及多个淋巴结回声，较大者大小约25 mm×10 mm，皮髓质分界清晰，血流信号丰富。病理结果：（左肘部淋巴结）猫抓病.
Figure 1. Image of high frequency ultrasonography of lymph nodes.
图 2 淋巴结Vmax、RI在浅表淋巴结病变中的诊断效能
Figure 2. Diagnostic efficacy of lymph node Vmax and RI in superficial lymph node lesions.
表 1 两组患者高频超声图像特征比较
Table 1. Comparison of high-frequency ultrasound images features between the two groups of patients (Mean±SD)
指标 恶性组（n=61） 良性组（n=45） Z/t/χ2 P VS[n(%)] 22.04 < 0.01 Ⅰ 3（4.92） 28（62.22） Ⅱ 32（52.46） 7（15.56） Ⅲ 16（26.23） 5（11.11） Ⅳ 10（16.39） 5（11.11） L/S < 2 [n(%)] 46（75.41） 4（8.89） 45.98 < 0.01 淋巴结Vmax（cm/s） 26.85±5.71 21.06±5.42 5.27 < 0.01 淋巴结Vmin（cm/s） 7.23±1.52 7.69±1.56 1.52 0.13 RI 0.75±0.18 0.56±0.13 6.01 < 0.01 
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表 2 高频超声与病理检查结果
Table 2. Results of high-frequency ultrasound and pathological examination (n)
高频超声诊断 病理诊断 合计 恶性 良性 恶性 55 9 64 良性 6 36 42 合计 61 45 106
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表 3 淋巴结Vmax、RI在浅表淋巴结病变中的诊断效能
Table 3. Diagnostic efficacy of lymph node Vmax and RI in superficial lymph node lesions
指标 最佳预测临界点 AUC 95%CI 敏感性（%） 特异度（%） Z P 淋巴结Vmax 24.37 0.723 0.628~0.805 59.02 73.33 4.541 < 0.05 RI 0.64 0.823 0.737~0.890 77.05 77.78 8.016 < 0.05
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