超声弹性应变率比值在颈部淋巴结良恶性鉴别诊断中的应用价值探讨

摘要

Objective To evaluate the clinical value of strain ratio using real‐time elastosonography in differential diagno‐sis of benign and malignant superficial cervical lymph nodes .Methods Elasticity imaging was used to examine 38 healthy volunteers with 66 benign lymph nodes and 70 lung cancer patients with 70 malignant lymph nodes .The stain ratio was obtained through normal soft tissues and lymph nodes .ROC (Receiver operation characteristic ) curves were plotted to e‐valuate the diagnostic performance of strain ratio .Results There were 70 malignant lymph nodes and 66 benign ones in our research .The mean of elastic stain ratio of benign and malignant was 2 .53 ± 0 .82 and 1 .08 ± 0 .49 ( P <0 .05) .The cut off point of stain ratio was determined as 1 .950 .The sensitivity ,specificity ,and accuracy were 77 .0% ,97 .0% and 86 .8% respectively in differential diagnosis of benign and malignant cervical lymph nodes .The area under the curve was 0 .918 .Conclusion The stain ratio is valuable for the differential diagnosis of malignant and benign cervical lymph nodes .%目的：探讨超声弹性应变率比值在颈部淋巴结良恶性鉴别诊断中的应用价值。方法分析70例70个经穿刺病理证实的恶性淋巴结超声弹性图像以及66例66个健康志愿者的颈部淋巴结超声弹性图像，计算所观察淋巴结与同等深度周边正常软组织的弹性应变率比值（strain rate）。构建受试者应用曲线，建立最佳截断值。结果136个颈部淋巴结中，恶性70个，良性66个。恶性结节应变率比值均值为2．53±0．82，良性淋巴结应变率比值的均值为1．08±0．49。两者差别有统计学意义（ P ＜0．05）。构建 ROC曲线分析得出，以1．950为诊断的最佳临界点，对应的曲线下面积为0.918，以1．950为弹性成像应变率比值临界点判断颈部淋巴结良恶性的敏感性、特异性和准确性分别为77．0％、97.0％、86．8％。结论超声弹性应变率比值在颈部淋巴结良恶性的鉴别诊断中有较高的诊断应用价值。