Liu N X, Tang L N, Wang Y Q, Huang W Q
Department of Ultrasound, Fujian Cancer Hospital, Affiliated Tumor Hospital of Fujian Medical University, Fuzhou 350014, China.
Zhonghua Yi Xue Za Zhi. 2020 Aug 4;100(29):2258-2262. doi: 10.3760/cma.j.cn112137-20200221-00390.
To investigate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of benign and malignant lateral cervical lymph nodes. One hundred and fifteen cases of suspected lymph nodes disease, 60 males, 55 females, between November 2018 and June 2019 from clinic and inpatient in Fujian Cancer Hospital were collected. Routine ultrasound and CEUS were performed in 115 cases of lateral cervical lymph nodes. All cases underwent ultrasound-guided biopsy, and were divided into two groups of benign and malignant lymph nodes according to pathological results. The differences between the two groups were analyzed and statistically analyzed. The rate and frequency were used to qualitatively describe the ultrasound performance and observed lymph node morphology between the two groups of routine ultrasound and CEUS. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value were used to evaluate the efficacy of routine ultrasound and CEUS. There were 37 cases of benign lymph nodes and 78 cases of malignant lymph nodes. In benign lymph nodes, 51.4% (19/37) showed uniform high enhancement, and 48.6% (18/37) showed uneven or circular enhancement with clear boundaries and no focal enhancement area. In malignant lymph nodes, 94.9% (74/78) showed uneven enhancement, and only 5.1% (4/78) showed uniform enhancement. The difference of ultrasonic contrast medium uniformities in differentiating benign from malignant was statistically significant (0.001). The sensitivity, accuracy, negative predictive value and positive predictive value of routine ultrasound to differentiate benign and malignant lymph nodes were 64.1%, 65.2%, 47.2%, and 66.7%, respectively, while the corresponding values of CEUS were 93.6%, 75.7%, 73.7% and 83.9%. CEUS may provide a valuable basis for the differential diagnosis of benign and malignant lateral cervical lymph nodes.
探讨超声造影（CEUS）在诊断颈部侧方良恶性淋巴结中的价值。收集2018年11月至2019年6月福建医科大学附属肿瘤医院门诊及住院的115例疑似淋巴结疾病患者，其中男性60例，女性55例。对115例颈部侧方淋巴结患者进行常规超声及CEUS检查。所有病例均接受超声引导下活检，并根据病理结果分为良性和恶性淋巴结两组。分析两组之间的差异并进行统计学分析。采用率和频数对两组常规超声及CEUS的超声表现及观察到的淋巴结形态进行定性描述。采用灵敏度、特异度、准确度、阴性预测值和阳性预测值评估常规超声和CEUS的效能。良性淋巴结37例，恶性淋巴结78例。良性淋巴结中，51.4%（19/37）表现为均匀高增强，48.6%（18/37）表现为不均匀或环状增强，边界清晰，无局灶性增强区。恶性淋巴结中，94.9%（74/78）表现为不均匀增强，仅5.1%（4/78）表现为均匀增强。超声造影剂均匀性在鉴别良恶性方面的差异具有统计学意义（P<0.001）。常规超声鉴别良恶性淋巴结的灵敏度、准确度、阴性预测值和阳性预测值分别为64.1%、65.2%、47.2%和66.7%，而CEUS的相应值分别为93.6%、75.7%、73.7%和83.9%。CEUS可为颈部侧方良恶性淋巴结的鉴别诊断提供有价值的依据。
