本文選題：頸部淋巴結(jié) + 超聲檢查��； 參考：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討二維髓質(zhì)、三維血流及彈性成像對(duì)頸部腫大淋巴結(jié)良惡性鑒別診斷的臨床應(yīng)用價(jià)值。方法：對(duì)73例患者的100個(gè)頸部腫大淋巴結(jié)分別進(jìn)行二維灰階超聲(B超)、三維彩色能量多普勒(3D-CDE)及彈性成像(UE)檢查。所有淋巴結(jié)經(jīng)病理及隨訪證實(shí)分為良性組(淋巴結(jié)核、淋巴結(jié)炎及反應(yīng)性增生淋巴結(jié))和惡性組(淋巴瘤和轉(zhuǎn)移性淋巴結(jié)),觀察二維髓質(zhì)位置形態(tài)、三維血流分布模式及反映組織硬度的彈性成像圖,評(píng)價(jià)這三種技術(shù)對(duì)頸部腫大淋巴結(jié)進(jìn)行良惡性鑒別的診斷效能并分析兩組超聲聲像圖特點(diǎn)。結(jié)果：100個(gè)頸部腫大淋巴結(jié),B超、3D-CDE、UE診斷淋巴結(jié)良惡性的靈敏度、特異度及準(zhǔn)確度分別為87.9%,71.4%,81.0%；94.8%,85.7%,91.0%；89.7%,83.3%,87.0%；B超、3D-CDE及UE聯(lián)合(并聯(lián))診斷淋巴結(jié)良惡性的靈敏度、特異度及準(zhǔn)確度分別為96.6%,66.7%,77.0%；三種檢查技術(shù)的聲像圖特征在鑒別良惡性頸部淋巴結(jié)方面差異均有統(tǒng)計(jì)學(xué)意義(P0.05)；各超聲征象與病理吻合程度的Kappa值分別為0.592,0.893,0.707。結(jié)論：三維血流分布模式的診斷效能最高,臨床應(yīng)用價(jià)值最好。彈性成像硬度分級(jí)對(duì)頸部淋巴結(jié)的鑒別診斷具有一定價(jià)值,與二維髓質(zhì)比較價(jià)值更大,有望成為鑒別診斷頸部淋巴結(jié)病變的一項(xiàng)重要新手段。
[Abstract]:Objective: to evaluate the clinical value of two-dimensional medulla, three-dimensional blood flow and elastic imaging in differential diagnosis of benign and malignant cervical lymph nodes. Methods: 100 enlarged cervical lymph nodes of 73 patients were examined by two dimensional gray scale ultrasound (B US), three dimensional color energy Doppler (3D-CDE) and elastic imaging (UE). All lymph nodes were divided into benign group (lymph node nucleus, lymphadenitis and reactive hyperplasia lymph node) and malignant group (lymphoma and metastatic lymph node) by pathology and follow up. Three-dimensional blood flow pattern and elastic imaging images reflecting tissue hardness were used to evaluate the diagnostic efficacy of these three techniques in differentiating benign and malignant cervical lymph nodes and to analyze the characteristics of two groups of ultrasound images. Results: the sensitivity, specificity and accuracy in the diagnosis of benign and malignant lymph nodes were 87.9% and 71.4%, respectively. The sensitivity, specificity and accuracy of B-ultrasound 3D-CDEU UE in the diagnosis of benign and malignant lymph nodes were 87.9%, 71.4% and 91.0%, 91.0%, 83.33% and 87.0%, respectively, and the sensitivity of 3D-CDE and UE combined with UE in the diagnosis of benign and malignant lymph nodes were analyzed, and the sensitivity of 3D-CDE and UE combined with UE in the diagnosis of benign and malignant lymph nodes were analyzed. The specificity and accuracy were 96.66.70.The sonographic features of the three examination techniques were significantly different in differentiating benign and malignant cervical lymph nodes (P0.05); the Kappa values of each ultrasound sign and pathological coincidence were 0.5920.893n0.707 respectively. Conclusion: the three-dimensional blood flow distribution model has the highest diagnostic efficacy and the best clinical application value. Elastic imaging hardness grading has a certain value in the differential diagnosis of cervical lymph nodes and is more valuable than two-dimensional medulla. It is expected to be an important new method in the differential diagnosis of cervical lymph node lesions.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.1

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