摘要
目的探讨支气管超声弹性成像对肺门及纵隔淋巴结良恶性鉴别诊断的价值。方法选择60例肺门及纵隔淋巴结肿大患者作为研究对象,对患者实施常规超声检查、支气管超声弹性成像检查、针吸活检病理检查。参照诊断金标准(针吸活检病理诊断结果),比较常规超声、超声弹性成像在肺门及纵隔淋巴结定性诊断中的结果。结果超声弹性成像在肺门及纵隔恶性淋巴结定性诊断中的灵敏度、特异度、准确率分别为97.22%、95.92%、96.47%,均高于常规超声(χ^2=5.063、5.018、10.014,P<0.05)。超声弹性成像与针吸活检病理诊断结果间具有良好的一致性,常规超声与针吸活检病理诊断结果间具有中等一致性,Kappa值分别为0.815、0.634。恶性淋巴结组的淋巴结短径、收缩期峰值速度、舒张期末血流速度,均高于良性淋巴结组(t=5.063、5.427、6.182,P<0.05);恶性淋巴结组的搏动指数、阻力指数,均低于良性淋巴结组(t=4.935、5.021,P<0.05);恶性淋巴结组的应变率比值、弹性最小值、弹性最大值、弹性平均值,均高于良性淋巴结组(t=11.311、5.960、7.933、7.989,P<0.05)。结论支气管超声弹性成像可对肺门及纵隔淋巴结的良恶性予以准确鉴别区分,具有良好的定性诊断价值,可作为肺门及纵隔淋巴结诊断的辅助手段。
Objective To investigate the value of bronchial ultrasound elastography in the differential diagnosis of benign and malignant hilar and mediastinal lymph nodes.Methods 60 patients with hilar and mediastinal lymphadenopathy were enrolled in the study.Patients underwent routine ultrasonography,bronchial ultrasound elastography,and needle biopsy pathological examination.The gold standard(the result of pathological diagnosis of needle aspiration biopsy)was compared with the results of conventional ultrasound and ultrasound elastography in the qualitative diagnosis of hilar and mediastinal lymph nodes.Results The sensitivity,specificity and accuracy of ultrasound elastography in the qualitative diagnosis of hilar and mediastinal malignant lymph nodes were 97.22%,95.92%and 96.47%,respectively,which were higher than conventional ultrasound(χ^2=5.063,5.018,10.014,P<0.05).There was good agreement between ultrasound elastography and needle biopsy pathological diagnosis.The results of conventional ultrasound and needle biopsy have a moderate consistency,Kappa values were 0.815,0.634,respectively;lymph node short diameter of malignant lymph node group,The peak systolic velocity and the end-diastolic blood flow velocity were higher than those in the benign lymph node group(t=5.063,5.427,6.182,P<0.05).The pulsatility index and resistance index of the malignant lymph node group were lower than those of the benign lymph node group(t=4.935,5.021,P<0.05);the strain rate ratio,elastic minimum,elastic maximum,and elastic mean of the malignant lymph node group were higher than those of the benign lymph node group(t=11.311,5.960,7.933,7.989,P<0.05).Conclusion Bronchial ultrasound elastography can accurately distinguish between benign and malignant hilar and mediastinal lymph nodes,and has good qualitative diagnostic value.It can be used as an auxiliary tool for the diagnosis of hilar and mediastinal lymph nodes.
作者
王晓燕
何欣
姚丽
WANG Xiaoyan;HE Xin;YAO Li(The Third People's Hospital of Pingdingshan,Pingdingshan,467000)
出处
《实用癌症杂志》
2020年第7期1207-1210,共4页
The Practical Journal of Cancer
关键词
肺门
纵隔
淋巴结
定性诊断
超声弹性成像
Hilar
Mediastinum
Lymph node
Diagnosis
Ultrasound elastography
