Yoshinaka H, Nishi M, Kajisa T, Kuroshima K, Morifuji H
J Clin Ultrasound. 1985 Mar-Apr;13(3):153-60. doi: 10.1002/jcu.1870130302.
The celiac axis could be visualized with ultrasound in 140 out of 166 cases (84%). Failure to identify the celiac axis was associated with extensive metastases to the celiac lymph nodes in 73% (19/26) of these cases. The location of lymph nodes in this region could be determined using the celiac axis and its branches as land marks. Celiac lymph nodes can be roughly classified into three types: Type 1--unclear margins and relatively uniform diffuse internal echoes, Type 2--clear margins and weak internal echoes, and Type 3--clear margins and scattered, large internal echoes, frequently seen with notchings. Metastases in celiac lymph nodes were found in 53 of 166 cases, based on histological examination of surgically removed nodes. A preoperative ultrasonic examination indicated lymph node metastases in 39 out of the 53 cases (sensitivity of 74%) and no lymph node metastases in 108 of the remaining 113 cases (specificity of 96%). Most lymph nodes with metastases were of Types 2 or 3. The longer the diameter of the lymph node or the larger the ratio of metastatic area to node cross-sectional area, the higher the detection rate tended to be. These results indicate that ultrasound can be very useful in screening patients for celiac lymph node metastases.
在166例患者中，140例（84%）可通过超声显示腹腔干。在这些病例中，73%（19/26）未能显示腹腔干与腹腔淋巴结广泛转移有关。该区域淋巴结的位置可通过以腹腔干及其分支为标志来确定。腹腔淋巴结大致可分为三种类型：1型——边界不清，内部回声相对均匀且弥漫；2型——边界清晰，内部回声弱；3型——边界清晰，内部回声散在、较大，常见切迹。根据手术切除淋巴结的组织学检查，166例中有53例发现腹腔淋巴结转移。术前超声检查显示，53例中有39例有淋巴结转移（敏感性为74%），其余113例中有108例无淋巴结转移（特异性为96%）。大多数有转移的淋巴结为2型或3型。淋巴结直径越长或转移面积与淋巴结横截面积之比越大，检出率往往越高。这些结果表明，超声在筛查腹腔淋巴结转移患者方面非常有用。
