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目的探讨原发性胰腺癌引流区转移淋巴结的分布特点及彩色多普勒超声表现。方法经手术病理诊断为胰腺癌的患者21例,均经增强CT、手术或病理诊断有胰腺周围淋巴结转移,以患者胰腺引流区淋巴结的短径≥1.0cm为可疑淋巴结转移,结合彩色多普勒超声图像将原发灶分为胰头癌和胰体尾癌两类,分别统计其可疑转移淋巴结出现的部位,并观察大小、数目、形态、血供特点等。结果本组21例胰腺癌患者的彩色多普勒超声图像中,共计43个部位观察到转移淋巴结;随原发部位不同,引流区淋巴结转移灶的超声显示率也有差别;彩色多普勒超声较易显示腹腔干、肝十二指肠韧带、肠系膜根部、腹主动脉及下腔静脉周围淋巴结转移灶;转移淋巴结多呈圆形及类圆形低回声包块,融合多见,边界欠清,皮质回声偏高不均质,淋巴门偏心或消失;彩色多普勒显示血流信号分布不规则,非淋巴门处可见穿支血管。结论彩色多普勒超声能够较准确地发现原发性胰腺癌的淋巴结转移情况。
Objective To investigate the distribution of lymph node metastasis and color Doppler echocardiography in primary pancreatic cancer. Methods Twenty-one patients were diagnosed as pancreatic cancer by operation and pathology. All cases had pancreatic lymph node metastasis by enhanced computed tomography (CT), surgery or pathological diagnosis. Patient with lymph node metastasis of small lymph node ≥1.0cm in the drainage area of the pancreas was considered as suspicious lymph node metastasis. Combined with color Doppler Ultrasound images of the primary tumor is divided into two types of pancreatic cancer and pancreatic body tail cancer, respectively, statistics of the suspicious metastatic lymph nodes appear and observe the size, number, shape, blood supply characteristics. Results A total of 43 sites of metastatic lymph nodes were observed in color Doppler ultrasound images of 21 patients with pancreatic cancer. With the different primary sites, there was also a difference in the ultrasound display rate of lymph node metastasis in drainage area. Compared with color Doppler ultrasound, Easy to show celiac, hepatoduodenal ligament, mesenteric root, abdominal aorta and inferior vena cava lymph node metastasis; metastatic lymph nodes mostly round and round hypoechoic mass, fusion more common, the border is not clear, Cortical hyperechogenic heterogeneity, eccentric or disappearance of the lymphatic door; color Doppler flow signal distribution is irregular, non-lymph nodes can be seen perforating blood vessels. Conclusion Color Doppler ultrasound can accurately detect the lymph node metastasis of primary pancreatic cancer.