摘要
目的探讨超声弹性成像评分法、弹性应变率比值法、弹性面积比法对肺癌颈部淋巴结转移中的诊断价值。方法对154例215个颈部淋巴结进行超声弹性成像检查。其中病理证实为肺癌颈部转移性淋巴结的为110例110个,健康对照组颈部良性淋巴结为44例105个。弹性成像参数包括:1以Itoh五分法;2与不同参照组织的弹性应变率比值(周围同等深度组织及同侧颈前肌群);3弹性面积比。构建受试者应用曲线,比较上述参数对肺癌颈部淋巴结转移的诊断价值。结果 Itoh五分法曲线下面积为0.875,最佳截断值为4分,其对应敏感性、特异性、准确性及约登指数分别为69.5%、90.0%、80.0%、0.595;以同等深度组织为参照的弹性应变率比值法曲线下面积为0.936,最佳截断值为1.750,其对应敏感性、特异性、准确性及约登指数分别为82.9%、90.9%、87.0%、0.738;以同侧颈前肌群为参照的弹性应变率比值法曲线下面积为0.743,最佳截断值为1.020,其对应敏感性、特异性、准确性及约登指数分别为71.4%、65.5%、68.4%、0.369;弹性面积比法曲线下面积为0.949,最佳截断值为0.945,其对应敏感性、特异性、准确性及约登指数分别为93.3%、91.8%、92.6%、0.851。面积比法与以同等深度组织为参照的弹性应变率比值法的准确性均优于Itoh五分法(P<0.05)。结论各弹性参数在肺癌颈部淋巴结转移的诊断中有一定价值,其中,以同等深度组织为参照的超声弹性应变率比值法较以同侧颈前肌群为参照的诊断价值高,其与弹性面积比法在肺癌颈部转移性淋巴结的诊断中均具有一定的应用价值。
Objective To discuss the diagnostic value of Itoh5 scoring system, strain ratio and area ratio measure method in cervical lymph node metastasis of lung cancer. Methods Elasticity imaging was used to examine 44 healthy volunteers with 105 benign lymph nodes and 110 patients with 110 cervical lymph nodes metastasis of lung cancer pathologically diag nosed. The lymph nodes were scored and calculated with （1） Itoh5 scoring system; （2） strain ratio （calculated using for ref erenee by the same deep tissue and the anterior cervical muscles respectively） ; （3） area ratio. According to pathologic diagnosis, the diagnostic performance of these methods was evaluated with receiver operating characteristic curve （ROC）. Results The area under curve （AUC） of Itoh5 scoring system was 0. 875, the cut-off point was 4, the sensitivity, speeificity, accruacy and the Youden index were 69. 5%, 90.0%, 80.0%, 0. 595, respectively; those of strain ratio measure method reference by the same deep tissue were 0. 936, 1. 750, 82.9%, 90.9%, 87.0%, 0. 738, respectively; by the anterior cervicalmuscules, those were 0.743, 1.02, 71.4%, 65.5%, 68.4%, 0.369, respectively; and those of area ratio were 0. 949, 0. 945, 93.3%, 91.8%, 92.6%, 0. 851, respectively. The diagnostic performance of strain ratio using for reference by the same deep tissue and area ratio had higher accuracy than Itoh5 scoring system （ P 〈0.05）. Conclusion Different parameter in ultrasonic elastography had value in the cervical lymph node metastasis of lung cancer. The diagnos tic performance of strain ratio using for reference by the same deep tissue had higher value than by the anterior cervical muscules. The diagnostic value of strain ratio and area ratio were high in cervical lymph node metastasis of lung cancer.
出处
《医学影像学杂志》
2015年第10期1788-1791,共4页
Journal of Medical Imaging
基金
上海市卫生和计划生育委员会科研基金项目(编号:20144Y0168)
关键词
超声弹性成像
颈部淋巴结
弹性应变率比值
面积比法
Ultrasonic elastography
Superficial cervical lymph nodes
Strain ratio
Area ratio
