Abstract
Objective:To compare the diagnostic value for judging benign and malignant cervical lymph nodes of real‐time static ultrasound elastography with that of traditional methods such as 2D grayscale ultrasonography ,color Doppler ,etc . Methods :A total of 322 cervical lymph nodes from 311 patients ,who were treated during Jan 2012 and Dec 2013 ,were selected .And the benignancy and malignancy of all lymph nodes were confirmed by pathology .The lesions were examined by grayscale ultrasonography and the major and minor diameters were recorded ,the ratio between which was calculated .The vascular type , including lymphatic type , central type , peripheral type and mixed type , were classified by color Doppler ultrasonography ,and the resistance index (RI) was also recorded .Ultrasound elastography were undertaken for the lesions ,so as to compare the hardness of lesions in region of interest (ROI) with that of peripheral tissues by elasticity figure and classify the elasticity figure .Receiver operating characteristic(ROC) curves were drawn so as to evaluate the diagnostic value of each index for determining the benignancy and malignancy of cervical lymph nodes .Results:Among the 322 lymph nodes ,which were confirmed by pathology ,73 were benign and the other 249 were malignant .The cutoff value of major‐minor diameter ratio was 1 .5789 ,and the AUC was 0 .766 ,of which accuracy ,sensitivity ,specificity were 65 .22% ,61 .40% ,78 .10% , respectively .The cutoff value of RI was 0 .655 ,and the AUC was 0 .787 ,of which accuracy ,sensitivity ,specificity were 72 .98% ,73 .10% ,72 .60% ,respectively .According to vascular type ,rates of malignant lesions for lymphatic type ,central type ,peripheral type ,mixed type were 11 .8% ,52 .9% ,83 .3% ,88 .8% ,respectively ,and the difference among them was statistically significant(P<0 .01) .Elasticity classification ≥ Ⅲ was set as criteria for judging benignancy and malignancy of lymph nodes .Among the 249 malignant lymph nodes ,222 were classified as≥ Ⅲ .Among the 73 benign lymph nodes ,31 were classified as ≤ Ⅱ .The accuracy of ultrasonography elasticity classification for judging benignancy and malignancy of lymph nodes was 78 .57% .The difference among major‐minor diameter ratio ,RI ,elasticity classification regarding accuracy for judging benignancy and malignancy of lymph nodes was statistically significant (P<0 .05) .Conclusions :Major‐minor diameter ratio ,RI ,vascular type classification and elasticity classification show diagnostic value in determining benign or malignant cervical lymph nodes . The accuracy of ultrasonography elasticity classification in determining benign or malignant cervical lymph nodes is superior to that of RI and major‐minor diameter ratio ,while the accuracy of RI is superior to that of major‐minor diameter ratio .According to vascular type ,the rates of lymph nodes malignant lesions for peripheral and mixed type is superior to that of central and lymphatic type .关键词
超声弹性/淋巴结/鉴别诊断Key words
Ultrasound elasticity/Lymph node/Differential diagnosis分类
医药卫生
