中国癌症杂志 ›› 2018, Vol. 28 ›› Issue (7): 520-524.doi: 10.19401/j.cnki.1007-3639.2018.07.008

• 论著 • 上一篇    下一篇

实时剪切波弹性成像在鉴别淋巴瘤与转移性淋巴结中的应用价值

马英超1,刘津灵1,王 巍2   

  1. 1. 北京大学首钢医院超声科,北京100144 ;
    2. 解放军总医院第一附属医院超声科,北京100048
  • 出版日期:2018-07-30 发布日期:2018-08-10
  • 通信作者: 刘津灵 E-mail: liujinn51@163.com
  • 基金资助:
    解放军总医院临床科研扶持基金(三〇四专项)(2016FC-304M-TSYS-07)。

The value of real-time shear wave elastography in differential diagnosis between lymphoma and metastatic lymph node

MA Yingchao1, LIU Jinling1, WANG Wei2   

  1. 1. Department of Ultrasound, Peking University Shougang Hospital, Beijing 100144, China; 2. Department of Ultrasound, First Affiliated Hospital of PLA General Hospital, Beijing 100048, China
  • Published:2018-07-30 Online:2018-08-10
  • Contact: LIU Jinling E-mail: liujinn51@163.com

摘要: 背景与目的:淋巴瘤与转移性淋巴结均可表现为体积增大,实时剪切波弹性成像(shear wave elastography,SWE)能获得组织内部的弹性分布的定量信息,以不同色彩反映组织的软硬度。该研究旨在探讨SWE在鉴别淋巴瘤与转移性淋巴结中的应用价值。方法:采用回顾性、总结的研究方法,选取2016年4月—2017年3月在北京大学首钢医院诊治的疑似淋巴瘤与转移性淋巴结的颈部恶性淋巴结肿大的80例患者作为研究对象,所有患者都给予常规超声与SWE诊断,记录诊断参数与鉴别诊断价值。结果:在80例患者中,病理诊断为转移性淋巴结的患者40例(转移组),恶性淋巴瘤患者40例(淋巴瘤组)。淋巴瘤组的淋巴结直径显著长于转移组(P<0.05),两组长短径比值对比差异无统计学意义(P>0.05)。转移组淋巴结的弹性模量平均值与最大值显著高于淋巴瘤组(P<0.05)。以弹性模量平均值15.80 kPa为诊断界值时,灵敏度为95.3%,特异度为81.3%;以弹性模量最大值38.35 kPa为诊断界值时,灵敏度为85.0%,特异度为98.8%。受试者工作特征(receiver operating characteristic,ROC)曲线分析结果显示,应用淋巴结弹性模量平均值和最大值鉴别转移性淋巴结和淋巴瘤淋巴结的曲线下面积(area under curve,AUC)分别为0.945和0.952。结论:SWE在鉴别诊断转移性淋巴结与淋巴瘤的准确性较高,可给临床医师提供客观、直观的硬度信息,具有重要的临床诊断价值。

关键词: 实时剪切波弹性成像, 鉴别诊断, 淋巴瘤, 转移性淋巴结

Abstract: Background and purpose: Lymphoma and metastatic lymph node can both show volume increase. Real-time shear wave elastography (SWE) can obtain quantitative information of the elastic distribution within the tissue, and reflect hardness of the tissue in different colors. This study aimed to explore the values of SWE in differential diagnosis between lymphoma and metastatic lymph node. Methods: From Apr. 2016 to Mar. 2017, 80 patients with malignant lymphadenopathy of suspected lymphoma and metastatic lymph node in the Peking University Shougang Hospital were selected by reviewing and summarizing research methods. All patients were given conventional ultrasound and SWE diagnosis, and the diagnostic parameters and differential diagnostic value were recorded. Results: In the 80 patients, 40 patients were diagnosed with metastatic lymph nodes, 40 patients were diagnosed with malignant lymphoma. Patients’ lymph nodes in lymphoma group were significantly larger in diameter than those in metastasis group (P<0.05), there was no significant difference in the ratio of length to diameter between the two groups (P>0.05). The average and maximum elastic modulus values of metastasis group were significantly higher than those of lymphoma group (P<0.05). The sensitivity was 95.3% and the specificity was 81.3% when the mean elastic modulus value was 15.80 kPa (as the diagnostic boundary value). The sensitivity was 85.0% and the specificity was 98.8% when the maximum elastic modulus value was 38.35 kPa (as the diagnostic boundary value). The receiver operating characteristic (ROC) curve analysis showed that using the average and maximum elastic modulus values to differentiate metastatic lymph nodes from lymphoma lymph nodes, the area under curve (AUC) values were 0.945 and 0.952, respectively. Conclusion: SWE is of high accuracy in differential diagnosis between metastatic lymph node and lymphoma. It can provide objective and visual information to clinicians with important clinical diagnostic value.

Key words: Real-time shear wave elastography, Differential diagnosis, Lymphoma, Metastatic lymph node