头颈部癌患者颈部淋巴结的能量多普勒超声检查
Power Doppler sonography of cervical lymph nodes in patients with head and neck cancer.
作者信息
Ariji Y, Kimura Y, Hayashi N, Onitsuka T, Yonetsu K, Hayashi K, Ariji E, Kobayashi T, Nakamura T
机构信息
Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Sakamoto, Japan.
出版信息
AJNR Am J Neuroradiol. 1998 Feb;19(2):303-7.
PURPOSE
The purpose of this preliminary study was to evaluate the usefulness of power Doppler sonography in differentiating metastatic from nonmetastatic cervical lymph nodes in patients with cancer.
METHODS
Histologically proved metastatic (n = 71) and nonmetastatic (n = 220) lymph nodes were examined with power Doppler sonography in 77 patients with head and neck cancer. Power Doppler sonography was assessed for its ability to differentiate metastatic from nonmetastatic lymph nodes.
RESULTS
Power Doppler sonography showed characteristic features of parenchymal blood flow signal in 59 (83%) of the 71 metastatic lymph nodes. By contrast, only four (2%) of the 220 nonmetastatic nodes showed these power Doppler signals. In addition, power Doppler sonography showed high levels of sensitivity (83%) and specificity (98%) in depicting metastatic lymph nodes, which were superior to the values (66% sensitivity and 92% specificity) obtained by applying size criteria (transverse to longitudinal ratio). However, a combination of the two criteria (parenchymal color signal and transverse to longitudinal ratio) improved diagnostic accuracy to 92% sensitivity and 100% specificity.
CONCLUSION
Our preliminary findings suggest that the power Doppler criteria of no hilar flow, peripheral parenchymal nodal flow, and a transverse to longitudinal ratio of more than 0.65 together constitute a powerful tool for depicting metastatic lymph nodes in patients with cancer.
目的
本初步研究的目的是评估能量多普勒超声在鉴别癌症患者转移性和非转移性颈部淋巴结方面的实用性。
方法
对77例头颈部癌症患者的组织学证实为转移性（n = 71）和非转移性（n = 220）淋巴结进行能量多普勒超声检查。评估能量多普勒超声区分转移性和非转移性淋巴结的能力。
结果
能量多普勒超声在71个转移性淋巴结中的59个（83%）显示出实质血流信号的特征性表现。相比之下，220个非转移性淋巴结中只有4个（2%）显示出这些能量多普勒信号。此外，能量多普勒超声在描绘转移性淋巴结方面显示出高敏感性（83%）和特异性（98%），优于应用大小标准（横纵比）所获得的值（敏感性66%，特异性92%）。然而，将这两个标准（实质彩色信号和横纵比）结合可将诊断准确性提高到敏感性92%和特异性100%。
结论
我们的初步研究结果表明，无门部血流、周边实质淋巴结血流以及横纵比大于0.65的能量多普勒标准共同构成了一种用于描绘癌症患者转移性淋巴结的有力工具。
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