标题：高频超声用于浅表淋巴结良恶性鉴别的临床价值

      作者：黄春燕，陈冬菲，杨颖华    佛山市中医院超声科，广东 佛山 528000

      卷次： 2024年35卷14期

      【摘要】 目的 探讨高频超声用于浅表淋巴结良恶性鉴别的临床价值。方法 回顾性分析 2022年 2月至2024年1月佛山市中医院收治的64例浅表淋巴结患者的临床资料，所有患者均接受高频超声检查，依据病理组织活检结果将其分为良性组21例和恶性组43例，比较两组患者的高频超声图像特征，绘制受试者工作特征(ROC)曲线，并采用Kappa一致性检验分析高频超声对恶性浅表淋巴结的诊断价值。结果 良性组与恶性组患者的高频超声图像特征比较差异均有统计学意义(P<0.05)，其中恶性浅表淋巴结表现为类圆形/圆形，未发现淋巴门结构，内部可见微小的钙化灶/囊状回声，边界清晰度不佳，彩色多普勒血流显像(CDFI)呈现为周边/混合型；良性组患者超声检测的长径值、短径值、长径/短径比值、RI值分别为(2.84±0.29) cm、(1.20±0.16) cm、2.35±0.26、0.62±0.07，明显低于恶性组的(3.11±0.35) cm、(1.32±0.15) cm、2.50±0.27、0.85±0.09，动脉收缩期血流速度为(31.85±3.29) cm/s，明显快于恶性组的(26.99±2.76) cm/s，差异均有统计学意义(P<0.05)，但两组患者的舒张末期血流速度比较差异无统计学意义(P>0.05)；高频超声诊断恶性浅表淋巴结的敏感度、特异度、曲线下面积(AUC)、Kappa值分别为 83.72%、85.71%、0.847 (95%CI 0.739~0.955)、0.662。结论 高频超声对浅表淋巴结良恶性具有一定的鉴别诊断价值，值得临床推广应用。
      【关键词】 高频超声；浅表淋巴结；良恶性；鉴别；临床价值
      【中图分类号】 R445.1 【文献标识码】 A 【文章编号】 1003—6350（2024）14—2067—04

Clinical value of high-frequency ultrasound in differentiating benign and malignant superficial lymph nodes.HUANG Chun-yan, CHEN Dong-fei, YANG Ying-hua.
Department of Ultrasound, Foshan Hospital of Traditional ChineseMedicine, Foshan 528000, Guangdong, CHINA
【Abstract】 Objective To investigate the clinical value of high-frequency ultrasound in differentiating benign andmalignant superficial lymph nodes. Methods The clinical data of 64 patients with superficial lymph nodes admitted toFoshan Hospital of Traditional Chinese Medicine from February 2022 to January 2024 were retrospectively analyzed. Allpatients received high-frequency ultrasound examination and were divided into benign group (21 cases) and malignantgroup (43 cases) according to pathological biopsy results. The high-frequency ultrasound image features of the two groupswere compared. Receiver operating characteristic (ROC) curve was plotted, and Kappa consistency test was used to analyzethe diagnostic value of high-frequency ultrasound in malignant superficial lymph nodes. Results There were statisticallysignificant differences between the benign group and the malignant group in high-frequency ultrasound image features(P<0.05). The malignant superficial lymph nodes showed quasi-circular/circular shape and had no lymphatic portal struc-ture, with small calcification foci/cystic echoes inside, poor boundary resolution, which were displayed as peripheral/mixed type by color Doppler flow imaging (CDFI). The length diameter value, short diameter value, length diameter/short diameter ratio, and RI value detected by ultrasound in benign group were (2.84±0.29) cm, (1.20±0.16) cm, 2.35±0.26, and 0.62±0.07, respectively, significantly lower than (3.11±0.35) cm, (1.32±0.15) cm, 2.50±0.27, and 0.85±0.09 ofmalignant group; the systolic blood flow velocity was (31.85±3.29) cm/s, significantly higher than (26.99±2.76) cm/s ofmalignant group; the differences were statistically significant (P<0.05). There was no statistically significant differencein end-diastolic blood flow velocity between the two groups (P>0.05). The sensitivity, specificity, area under the ROCcurve (AUC), and Kappa value of high-frequency ultrasound for diagnosing malignant superficial lymph nodes were83.72%, 85.71%, 0.847 (95%CI 0.739-0.955), and 0.662, respectively. Conclusion High-frequency ultrasound has cer-tain diagnostic value in distinguishing between benign and malignant superficial lymph nodes, which is worthy of clini-cal promotion and application.
      【Key words】 High-frequency ultrasound; Superficial lymph nodes; Benign and malignant; Differentiating; Clini-cal value