The value and advantage of color Doppler and cervical multi-slice spiral CT in the diagnosis of cervical lymphadenopathy
10.3760/cma.j.cn115455-20210514-00644
- VernacularTitle:彩色多普勒超声与颈部多层螺旋增强CT诊断颈部淋巴结病变的价值分析
- Author:
Zhi ZHOU
1
;
Qinxue ZUO
;
Qi WU
;
Yufang LONG
;
Zhou FU
Author Information
1. 郴州市第一人民医院放射科，郴州 423000
- Keywords:
Ultrasonography, Doppler, color;
Spiral cone-beam computed tomography;
Diagnosis;
Cervical lymphadenopathy
- From:
Chinese Journal of Postgraduates of Medicine
2022;45(8):712-716
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the value and advantage of color Doppler and cervical multi-slice spiral CT (MSCT) in the diagnosis of cervical lymphadenopathy.Methods:A total of 130 patients with cervical lymphadenopathy diagnosed and treated in the Chenzhou First People′s Hospital from January 2019 to December 2020 were selected and received color Doppler ultrasound examination and MSCT examination. The results of pathological examination were used as the gold standard to compare the efficacy of the two methods in the differential diagnosis of benign and malignant cervical lymphadenopathy.Results:Ultrasound examination of malignant lymph nodes showed irregular boundaries, uneven internal hypoecho, and abundant blood flow signals in lymph nodes; ultrasound examination of benign lymph nodes showed uniform fine dot echo, uniform growth of endothelial medulla, clear and smooth boundary, no blood flow signal or scattered dot blood flow signal. The MSCT images of malignant lymph node showed irregular shape, blurred edge, obvious and uneven enhancement and higher rate of calcification. The aspect ratio of lymph nodes in benign lymph node was significantly higher than that in malignant lymph node (2.14 ± 0.48 vs. 1.92 ± 0.43), and the maximum blood flow velocity (V max), resistance index (RI) and blood flow (BF) in systolic period were significantly lower than those in lymph node [(21.38 ± 3.61) cm/s vs. (23.17 ± 2.55) cm/s, 0.62 ± 0.14 vs. 0.71 ± 0.17, (48.82 ± 13.51) ml/(min·100 g) vs. (65.61 ± 14.64) ml/(min·100 g)], there were statistical differences ( P<0.05). The most common blood flow types was lymphatic hilum type in benign lymph node, the proportion was 51.79% (29/56), while the most common type in malignant lymph node was marginal type and central type, the proportion was 44.59% (33/74) and 25.68% (19/74). The sensitivity, specificity, accuracy and Kappa value of ultrasound combined with MSCT in diagnosis were 92.86%, 95.95%, 94.62% and 0.890. Conclusions:Both color Doppler ultrasonography and MSCT can differentiate the benign and malignant of cervical lymph node lesions with better parameters such as lymph node imaging characteristics and blood flow distribution pattern, but the combined diagnosis has higher sensitivity, specificity and accuracy.
