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目的探讨三维能量多普勒超声(3DPDUS)在诊断颈部转移性淋巴结中的应用价值。方法对116个颈部肿大淋巴结行3DPDUS检查,观察三维血流分型,计算血管血流指数(VFI),绘制ROC曲线并与病理结果对照分析。结果行3D PDUS检查并经病理证实:转移性淋巴结67个,主要表现为周边型血流(53.73%)和混合型血流(32.84%),VFI为4.781±3.000;炎性反应性增生49个,主要表现为中央型血流(73.47%)和无血流型(18.37%),VFI为1.429±1.012;上述差异均有统计学意义(P<0.05)。当选取VFI=2.652为最佳诊断界点,ROC曲线下面积(AUC)为0.907、灵敏度为79.1%、特异度为87.8%。结论三维能量多普勒血流分型和定量参数VFI对诊断颈部转移性淋巴结有较高的应用价值。
Objective To investigate the value of three-dimensional energy Doppler ultrasound (3DPDUS) in the diagnosis of cervical lymph node metastasis. Methods One hundred and sixty-one cervical lymph nodes were examined by 3DPDUS. The three-dimensional blood flow patterns were observed and the vascular blood flow index (VFI) was calculated. The ROC curve was drawn and compared with the pathological results. Results The results of 3D PDUS were confirmed by pathology. There were 67 metastatic lymph nodes, which were mainly peripheral blood flow (53.73%) and mixed blood flow (32.84%), VFI was 4.781 ± 3.000 and inflammatory reactive hyperplasia (73.47%) and no blood flow type (18.37%), VFI was 1.429 ± 1.012. The above differences were statistically significant (P <0.05). When VFI = 2.652 was chosen as the best diagnostic endpoint, the area under the ROC curve (AUC) was 0.907, the sensitivity was 79.1% and the specificity was 87.8%. Conclusion Three-dimensional energy Doppler flow pattern and quantitative parameter VFI have high value in diagnosis of cervical lymph node metastasis.