颈部淋巴结非霍奇金淋巴瘤声像图特征

摘要

目的 探讨颈部淋巴结低度及中高度恶性非霍奇金淋巴瘤(NHL)的声像图特征.方法 依据WHO造血与淋巴组织2001年分型,回顾性分析两组(49例患者84个淋巴结)L/S比、门髓质区消失或存在(及其形态)、皮质回声(均匀或不均匀)及其类型、血流类型.结果 颈部淋巴结NHL多呈椭圆形或类圆形,门髓质区消失,皮质回声不均匀,门型及混合型血流.值得注意的特征:(1) L/S及皮质回声类型在两组间存在统计学差异,L/S≥2.0多提示低度恶性可能性大,皮质低回声区中出现网格状或絮状稍高回声时提示高度恶性可能性大.(2)门髓质区存在的淋巴结比例较高(39.3％)且形态纤细,门型(35.7％)及混合型中含门样(14.3％)血流的比例较高.结论 颈部淋巴结L/S及皮质回声可提示不同恶性度NHL,门髓质区及血流类型特征可提示NHL病变.%Objective To evaluate the sonographic characteristics of cervical lymph nodes infiltrated by low potential and moderate or severe malignant Non-Hodgkin's Lymphoma(NHL). Methods These nodes were clarified as two categories according to 2001 WHO Classification of tumors of haematopoietic and lymphoid tissues. The sono-granis of 49 cases with 84 cervical lymph nodes were reviewed in the study. We assessed their L/S ratio, hilar echo (present or absent), echcogenic pattern of cortex (homogeneous or heterogeneous) and distribution of intranodal vessels. Results Cervical lymphomatous nodes infiltrated by NHL frequently represented ellipsoid or round, absent of hilus, heterogeneous cortex, hilar or mixed vascular type. We noticed that 1. The statistical differences between the two categories were L/S ratio and heterogeneous cortex. The high percentage of L/S≥2 suggests the possibility of low potential malignancy , while septum-like or flocculent echo in the cortex suggest severe malignancy. 2. The percentage of nodes with thin hilar echo was high (39. 3%), hilar vascular type (35. 7%)and hilus-like vascular in the mixed type (14. 3%) were also high. Conclusions The L/S ratio and cortex type can suggest different malignant NHL, while the characteristics of hilar echo and vascular type can suggest NHL.