Department of Ultrasound, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Dentomaxillofac Radiol. 2022 Mar 1;51(3):20210293. doi: 10.1259/dmfr.20210293. Epub 2021 Nov 8.
To explore the value of contrast-enhanced ultrasound (CEUS) in predicting early lymph node metastasis in clinically node-negative oral cancer patients.
We recruited 42 patients (a total of 70 lymph nodes) with clinically node-negative oral cancer in the study. All of them received both conventional ultrasound (B-mode and power Doppler) and CEUS before operation and then they were taken for pathological examination to analyze the diagnostic accuracy. And their CEUS data were analyzed qualitatively and quantitatively.
The sensitivity and specificity of CEUS in the diagnosis of cervical lymph node metastasis of oral cancer were 82.7 and 82.9%, respectively. The accuracy of conventional ultrasound was only 67.1% while that of CEUS was up to 82.9%. The area under the cure (AUC) of CEUS in detecting lymph node metastasis was 0.828, which was higher than the 0.614 by conventional ultrasound, with statistically significant differences observed ( < 0.05). Most of the metastatic lymph nodes were characterized by inhomogeneous enhancement and the peak intensity (PI) of the metastatic group was lower than that of the non-metastatic group ( < 0.05).
Compared with conventional ultrasound, CEUS may have higher clinical value for predicting early lymph node metastasis in clinically node-negative oral cancer patients. And quantitative parameters obtained from CEUS may provide valuable information in the diagnosis of cervical lymph node metastasis.
探讨超声造影（CEUS）在预测临床颈部淋巴结阴性的口腔癌患者早期淋巴结转移中的价值。
本研究纳入 42 例（共 70 个淋巴结）临床颈部淋巴结阴性的口腔癌患者。所有患者均在术前接受常规超声（B 型和能量多普勒）和 CEUS 检查，然后进行病理检查以分析诊断准确性。并对其 CEUS 数据进行定性和定量分析。
CEUS 诊断口腔癌颈部淋巴结转移的灵敏度和特异度分别为 82.7%和 82.9%。常规超声的准确率仅为 67.1%，而 CEUS 的准确率高达 82.9%。CEUS 检测淋巴结转移的曲线下面积（AUC）为 0.828，高于常规超声的 0.614，差异有统计学意义（<0.05）。大多数转移性淋巴结呈不均匀增强，转移组的峰值强度（PI）低于非转移组（<0.05）。
与常规超声相比，CEUS 可能对预测临床颈部淋巴结阴性的口腔癌患者早期淋巴结转移具有更高的临床价值。CEUS 获得的定量参数可能为颈部淋巴结转移的诊断提供有价值的信息。
