多模态超声技术在浅表淋巴结病变良恶性鉴别诊断中的应用价值

The Application Value of Multimodal Ultrasound in the Differential Diagnosis of Benign and Malignant Superficial Lymph Node Lesions

摘要: 目的：探讨多模态超声技术(超声评分法、声触诊组织量化成像、超声造影技术)在浅表淋巴结病变良恶性鉴别诊断中的应用价值。方法：选取126例浅表肿大淋巴患者为研究对象，对选定的126个淋巴结进行常规超声检查、声触诊组织量化成像检查及超声造影检查，并存图，然后超声引导下活检穿刺获得病理，综合分析作出定性诊断，并与病理对照分析。结果：病理结果：126个患者浅表淋巴结中，良性51个，均为反应性增生，恶性75个，其中转移性淋巴结48个，淋巴瘤27个。超声评分法结果：敏感度(43/56)为76.8%，特异度(62/70)为88.6%，准确度(105/126)为83.3%。VTIQ结果：敏感度(45/50)为90.0%，特异度(70/76)为92.1%，准确度(115/126)为91.3%。造影结果：敏感度(45/64)为70.3%，特异度(56/62)为90.3%，准确度(101/126)为80.2%。多模态联合诊断：敏感度(49/53)为92.5%，特异度(71/73)为97.3%，准确度(120/126)为95.2%。多模态超声技术联合应用诊断敏感度、特异度、准确度较单一方法均提高，差别有统计学意义(P < 0.05)。结论：多模态超声技术联合应用能够提高对浅表肿大淋巴结病变的定性诊断价值，值得推广应用。

Abstract: Objective: To evaluate the value of multimodal ultrasonography (ultrasound score, virtual touch tissue image quantification, contrast-enhanced ultrasound) in the differential diagnosis of benign and malignant superficial lymph node lesions. Methods: 126 patients with superficial lymphadenopathy were selected as the research object, and 126 selected lymph nodes were examined by conventional ultrasound, acoustic palpation, quantitative imaging and contrast-enhanced ultrasound, and then biopsy was conducted under the guidance of ultrasound to obtain the pathology. Results: Pathological results: among the 126 patients with superficial lymph nodes, 51 were benign, all were reactive hyperplasia, 75 were malignant, 48 were metastatic lymph nodes and 27 were lymphomas. Ultrasonic scoring results: sensitivity (43/56) was 76.8%, specificity (62/70) was 88.6%, and accuracy (105/126) was 83.3%. VTIQ results: sensitivity (45/50) was 90.0%, specificity (70/76) was 92.1%, and accuracy (115/126) was 91.3%. Imaging results: sensitivity (45/64) was 70.3%, specificity (56/62) was 90.3%, and accuracy (101/126) was 80.2%. Multimodal combined diagnosis: sensitivity (49/53) was 92.5%, specificity (71/73) 97.3%, and accuracy (120/126) 95.2%. The sensitivity, specificity and accuracy of multimodal ultrasound combined with the single method were all improved, and the difference was statistically significant (P < 0.05). Conclusion: The combined application of multimodal ultrasound can improve the qualitative diagnosis value of superficial enlarged lymph node lesions.