二维剪切波弹性成像在颈部不同病理类型淋巴结鉴别诊断中的价值

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Abstract Objective To investigate the differential diagnosis value of two dimensional shear wave elastography (2D-SWE) in different pathological types of cervical lymph nodes. Methods A total of 101 patients with 145 enlarged cervical lymph nodes from October 2017 to May 2019 in the First Affiliated Hospital of Xinjiang Medical University were selected, and they underwent routine ultrasound and 2D-SWE examination. They were grouped according to lymph node pathology or results after six months of follow-up. Nodal tuberculosis, lymphoma and metastatic lymph nodes were selected as the case group (92 cases) and reactive hyperplasia lymph nodes as the control group (53 cases). Binary logistic regression was used to screen the elastic parameter with high differential value between the case group and the control group, and the diagnostic boundary value was determined by the comparison of this parameter between the groups and the ROC curve. Results Binary logistic regression showed that lymph node blood flow type, internal echo and 2D-SWE parameter Emax had higher differential diagnostic value between the case group and the control group. The Emax values of lymphomas, nodal tuberculosis and metastatic lymph nodes were higher than those of reactive hyperplasia lymph nodes (all P ＜ 0.01) and increased step by step. The Emax boundary value of lymphomas and reactive hyperplasia lymph nodes was 30.0 kPa (P ＜ 0.01), and the AUC, sensitivity and specificity were 0.783, 78.57% and 67.92%, respectively. The Emax boundary value of nodal tuberculosis and lymphoma was 47.53 kPa (P ＜ 0.01), and the AUC, sensitivity and specificity were 0.856, 71.43% and 91.30%, respectively. There was no significant difference in Emax value between reactive hyperplasia lymph nodes and nodal tuberculosis (P ＞ 0.05). Conclusion The 2D-SWE parameter Emax is the preferred elastic parameter to reflect the difference in hardness of cervical lymph nodes of different pathological types, which can be used as an important supplementary indicator for the ultrasonic differential diagnosis of cervical lymph node diseases.

Key words： Cervical lymph nodes Pathological types Differential diagnosis Two dimensional shear wave elastography

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	LIANG Kui WANG Xiaorong SONG Tao

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LIANG Kui WANG Xiaorong SONG Tao. Value of two dimensional shear wave elastography in differential diagnosis of cervical lymph nodes with different pathological types[J]. 中国医药导报, 2020, 17(25): 29-32,41.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I25/29

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