Chang D B, Yuan A, Yu C J, Luh K T, Kuo S H, Yang P C
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
AJR Am J Roentgenol. 1994 Apr;162(4):965-8. doi: 10.2214/ajr.162.4.8141027.
This study proposed to evaluate the efficacy of color Doppler sonography in detecting possible differences in blood flow patterns between malignant and benign cervical lymph nodes.
During a period of 12 months, the palpable cervical lymph nodes of 48 untreated patients were prospectively evaluated with color Doppler sonography and Doppler flow wave analysis. Histopathologic diagnoses were obtained by sonographically guided fine-needle aspiration biopsy and/or excisional biopsy.
We found 16 benign lymph nodes (four were tuberculous lymphadenitis, four were reactive hyperplasia, and eight were unspecified) and 32 malignant lymph nodes (13 were squamous cell carcinomas, nine were adenocarcinomas, four were small-cell carcinomas, three were lymphomas, and three were miscellaneous). Color Doppler flow patterns were seen in six (38%) of the 16 benign lymph nodes and in 29 (91%) of the 32 malignant lymph nodes. Twenty-six (81%) of the 32 malignant lymph nodes had abnormal flow patterns, with resistance indexes less than 0.6. However, three (19%) of the 16 benign lymph nodes also had abnormal flow patterns, and only seven (54%) of 13 squamous cell carcinomas had abnormal flow patterns.
Color Doppler sonography has limited clinical value in differentiating malignant from benign cervical lymph nodes and in obviating biopsy.
本研究旨在评估彩色多普勒超声在检测恶性和良性颈部淋巴结血流模式可能存在的差异方面的效能。
在12个月的时间里，对48例未经治疗患者可触及的颈部淋巴结进行前瞻性彩色多普勒超声和多普勒血流波分析评估。通过超声引导下细针穿刺活检和/或切除活检获得组织病理学诊断。
我们发现16个良性淋巴结（4个为结核性淋巴结炎，4个为反应性增生，8个未明确类型）和32个恶性淋巴结（13个为鳞状细胞癌，9个为腺癌，4个为小细胞癌，3个为淋巴瘤，3个为其他类型）。16个良性淋巴结中有6个（38%）呈现彩色多普勒血流模式，32个恶性淋巴结中有29个（91%）呈现该模式。32个恶性淋巴结中有26个（81%）血流模式异常，阻力指数小于0.6。然而，16个良性淋巴结中有3个（19%）血流模式也异常，13个鳞状细胞癌中只有7个（54%）血流模式异常。
彩色多普勒超声在鉴别颈部恶性与良性淋巴结以及避免活检方面的临床价值有限。
