B超、增强CT及增强MRI诊断舌癌颈部转移性淋巴结的价值比较∗

摘要

目的：评估和比较术前B超、增强CT及增强MRI对舌鳞状细胞癌颈部淋巴结转移的诊断及临床应用价值。方法收集26例经病理活检证实的舌癌患者，术前按颈部解剖分为152区，对颈部各区淋巴结均行增强CT、增强MRl及B超检查，与术后病理结果进行对比分析。结果26例患者的152个颈部分区中共分离出淋巴结1037枚，其中病理阳性淋巴结83枚。增强CT共检出28个阳性区，其中真阳性15个；增强MRI共检出28个阳性区，其中真阳性18个；B超共检出34个阳性区，其中真阳性24个。增强CT、增强MRI及B超的灵敏度分别为31�9％、38�3％和50�1％，特异度分别为87�6％、90�5％和90�5％，准确率分别为70�4％、74�3％和78�3％。结论舌癌患者术前通过行增强CT、增强MRI及B超检查均有助于辨别颈部淋巴结有无转移，B超可考虑为首选的影像学方法。%Objective To analyze the value of diagnosis and application of ultrasonography (USG), contrast⁃enhanced CT and contrast⁃enhanced MRI on metastatic neck lymph nodes in lingual squamous cell carcinoma. Methods Twenty⁃six patients with lingual squamous cell carcinoma confirmed by pathology were enrolled in this study. The neck dissection zones were divided into 152 levels, and the metastatic lymph nodes were detected by USG, contrast⁃enhanced CT and contrast⁃enhanced MRI. The results were compared with pathologic data. Results Among the 152 levels, 83 positive lymph nodes were detected out of 1037 lymph nodes. Con⁃trast⁃enhanced CT showed 28 positive levels, among which 15 were true positive; contrast⁃enhanced MRI detected 28 positive levels, among which 18 were true positive; USG showed 34 positive levels, and 24 levels were true positive. The sensitivity of contrast⁃en⁃hanced CT, contrast⁃enhanced MRI and USG were 31�9%, 38�3% and 50�1%;the specificity were 87�6%, 90�5% and 90�5%;the accuracy were 70�4%,74�3% and 78�3%, respectively. Conclusion USG, contrast⁃enhanced CT and contrast⁃enhanced MRI are useful for the diagnosis of metastatic neck lymph nodes of lingual squamous cell carcinoma, and USG can be regarded as the best choice.