| 摘要: |
| 目的 应用高帧率超声造影技术联合微血流增强模式，观察淋巴结灌注方向及微血管分布，评价其在鉴别不同大小的浅表淋巴结良恶性中的应用价值。方法 选取因诊断浅表异常淋巴结就诊于解放军总医院的患者，对上述121名患者共计121例淋巴结分别行常规帧率及高帧率超声造影，造影结束后调取常规帧率及高帧率造影动脉期图像，启动MFE功能，以1/2～1/3倍速播放并留存动态图像。分析两种造影帧率下，不同大小的良恶性淋巴结增强均匀性及灌注方向的区别。结果 良恶性淋巴结总体增强均匀性有统计学意义（χ2=14.546 p=0.000），在不同大小分组中，仅当淋巴结最大径大于2cm时，增强均匀性差异有统计学意义（χ2=9.614 p=0.002）。对于良性淋巴结，高帧率超声造影显示离心性灌注比例高于常规帧率超声造影（80.7% vs 61.4%；），差异有统计学意义（χ2=5.160 p=0.023）；对于转移性淋巴结，高帧率超声造影显示向心性灌注比例同样高于常规帧率超声造影（79.7% vs 62.5%），差异有统计学意义（χ2=4.600 p=0.032）。ROC曲线显示，随着淋巴结体积的减小，高帧率较常规帧率超声造影诊断准确性提高，特别是淋巴结最大径在0.5～1cm时，二者ROC曲线下面积分别为 0.817（P=0.001）、0.669（P=0.088）。结论 高帧率超声造影联合微血流增强模式可以更好的显示淋巴结内的血管结构及其灌注方向，从而准确反映良恶性淋巴结之间微循环差异，特别是对于体积较小的淋巴结其诊断能力优于常规帧率超声造影。 |
| 关键词: 高帧率超声造影 淋巴结 微血流增强 |
| DOI： |
| 投稿时间：2023-01-09修订日期：2023-02-12 |
| 基金项目: |
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| Clinical application of high-frame-rate contrast-enhanced ultrasound combined with microflow enhancement mode in differentiation of benign and malignant superficial lymph nodes of different sizes |
| hanpeng,zhulianhua,feixiang,liangshuyuan,luoyukun |
| (Chinese PLA General Hospital) |
| Abstract: |
| Objective To observe the direction of lymph node perfusion and microvascular distribution by high frame rate contrast-enhanced ultrasound combined with microflow enhancement mode, and to evaluate its application value in distinguishing benign and malignant superficial lymph nodes of different sizes. Methods A total of 121 patients admitted to the General Hospital of PLA for superficial abnormal lymph nodes were selected. Conventional frame rate and high frame rate contrast-enhanced ultrasound were performed on the lymph nodes of the above-mentioned patients. After the CEUS was performed, conventional frame rate and high frame rate contrast-enhanced arterial phase images were obtained, and MFE function was activated to play and save dynamic images at 1/2 ~ 1/3 speed. The enhancement uniformity and perfusion direction of benign and malignant lymph nodes of different sizes were analyzed under two contrast frame rates. Results There were significant differences in overall enhancement uniformity between benign and malignant lymph nodes (χ2=14.546 p=0.000). When the maximum diameter of lymph nodes was larger than 2cm, there was significant difference in enhancement uniformity among different size groups (χ2= 9.614p =0.002). For benign lymph nodes, H-CEUS showed a higher proportion of centrifugal fill-in perfusion than C-CEUS (80.7% vs 61.4%;), the difference was statistically significant (χ2=5.160 p=0.023). For metastatic lymph nodes, H-CEUS also showed a higher percentage of centripetal perfusion than C-CEUS (79.7% vs 62.5%), with statistical significance (χ2=4.600 p=0.032). ROC curve showed that with the decrease of lymph node volume, the accuracy of H-CEUS diagnosis was improved compared with C-CEUS, especially when the maximum diameter of lymph node was between 0.5 and 1cm, the areas under ROC curve were 0.817 (P=0.001) and 0.669 (P=0.088), respectively. Conclusion H-CEUS combined with MFE mode can better display the vascular structure and perfusion direction in lymph nodes, so as to accurately reflect the microcirculation difference between benign and malignant lymph nodes. Especially for small lymph nodes, H-CEUS has better diagnostic ability than C-CEUS. |
| Key words: High-frame-rate contrast-enhanced ultrasound Lymph nodes Micro flow enhancement |
