Yin Shanshan, Cui Qiuli, Wang Song, Fan Zhihui, Yan Kun
Department of Ultrasound, Key Laboratory of the Ministry of Education for Carcinogenesis and Translational Research, Peking University Cancer Hospital and Institute, Beijing, China.
J Ultrasound Med. 2018 Feb;37(2):385-395. doi: 10.1002/jum.14345. Epub 2017 Sep 6.
To retrospectively summarize the similarities and differences in contrast-enhanced ultrasound (US) findings for lymph node metastasis from adenocarcinoma, squamous carcinoma, and small cell lung cancer.
Patients who had received contrast-enhanced US examinations and had a histologic diagnosis of supraclavicular lymph node metastasis from lung cancer were included. The perfusion patterns on contrast-enhanced US images and time-intensity curve parameters were analyzed for the different pathologic types. The microvascular density and microvascular diameter were evaluated.
Totally, 61 patients were enrolled in this study, including 26 cases with lung squamous carcinoma, 26 with lung adenocarcinoma, and 9 with small cell lung cancer. Contrast-enhanced US perfusion showed no significant differences in enhancement uniformity during the arterial phase and in the presence of unenhanced areas of metastatic lymph nodes with the 3 different pathologic origins (P > .05), but fewer unenhanced areas could be seen in metastatic lymph nodes from adenocarcinoma. The analysis of the time-intensity curve parameters showed that there were significant differences in the peak intensity between metastatic lymph nodes from lung squamous carcinoma and lung adenocarcinoma (P < .05). The microvascular density of metastatic lymph nodes from adenocarcinoma was significantly higher than that of metastatic lymph nodes from squamous carcinoma and small cell lung cancer (P < .001; P = .0444), whereas the microvascular diameter of metastatic lymph nodes from adenocarcinoma was significantly smaller than that from squamous carcinoma and small cell lung cancer (P = .0277; P < .001).
Effects of the pathologic diagnosis should be considered when analyzing quantitative parameters of metastatic lymph nodes during contrast-enhanced US examinations, even in the same organ.
回顾性总结腺癌、鳞癌和小细胞肺癌淋巴结转移的超声造影（US）表现的异同。
纳入接受过超声造影检查且经组织学诊断为肺癌锁骨上淋巴结转移的患者。分析不同病理类型在超声造影图像上的灌注模式和时间-强度曲线参数。评估微血管密度和微血管直径。
本研究共纳入61例患者，其中肺鳞癌26例，肺腺癌26例，小细胞肺癌9例。超声造影灌注显示，3种不同病理来源的转移性淋巴结在动脉期增强均匀性及有无无增强区域方面无显著差异（P＞0.05），但腺癌转移性淋巴结中可见的无增强区域较少。时间-强度曲线参数分析显示，肺鳞癌和肺腺癌转移性淋巴结的峰值强度存在显著差异（P＜0.05）。腺癌转移性淋巴结的微血管密度显著高于鳞癌和小细胞肺癌转移性淋巴结（P＜0.001；P = 0.0444），而腺癌转移性淋巴结的微血管直径显著小于鳞癌和小细胞肺癌转移性淋巴结（P = 0.0277；P＜0.001）。
在超声造影检查分析转移性淋巴结定量参数时，即使在同一器官，也应考虑病理诊断的影响。
