彩色多普勒超声与多层螺旋CT扫描在颈部淋巴结结核诊断中的应用对比分析

新发传染病电子杂志 ›› 2017, Vol. 2 ›› Issue (4): 218-222.

彩色多普勒超声与多层螺旋CT扫描在颈部淋巴结结核诊断中的应用对比分析

郑秋婷^1,2, 董常峰³, 陆普选², 陈晓芳³, 罗婷婷³, 乐晓华³, 张芸², 刘俐⁴

1.汕头大学医学院,广东汕头 515041;
2.深圳市慢性病防治中心,广东深圳 518020;
3.深圳市第三人民医院,广东深圳 518112;
4.北京大学深圳医院超声影像科,广东深圳 518036

收稿日期:2017-09-10 出版日期:2017-11-30 发布日期:2020-07-14
通讯作者: 刘俐,Email：liuli126126@126.com;董常峰,Email：dongchangfeng7@163.com
基金资助:
深圳市知识创新计划重点项目（JCY20130401164750006; JCY20150207181301）

The comparative analysis of Color Doppler Ultrasonography and Multi-slice CT scan in the diagnosis of cervical lymph node tuberculosis

ZHENG Qiu-ting^1,2, DONG Chang-feng³, LU Pu-xuan², CHEN Xiao-fang³, LUO Ting-ting³, LE Xiao-hua³, ZHANG Yun², LIU Li⁴

1. Shantou University Medical College, Guangdong Shantou 515041, China;
2. Shenzhen Center for Chronic Disease Control, Guangdong Shenzhen 518020, China;
3. Shenzhen third people's hospital, Guangdong Shenzhen 518112, China;
4. Department of Ultrasonography,Shenzhen Hospital of Peking University, Guangdong Shenzhen 518036, China

Received:2017-09-10 Online:2017-11-30 Published:2020-07-14

摘要/Abstract

摘要： 目的对比分析彩色多普勒超声检查与多层螺旋CT扫描对颈部淋巴结结核的诊断差异。方法选取2014年1月至2016年12月深圳市慢性病防治中心及深圳市第三人民医院收治的40例病理确诊为颈部淋巴结结核的患者,同期均予以双侧颈部彩色多普勒超声检查及多层螺旋CT扫描,回顾性分析其临床影像资料,观察其影像表现,比较两种检查方法对颈部淋巴结结核检出率,计算两种方法的灵敏度、一致率及Kappa值。结果 40例患者中,彩色多普勒超声检查诊断颈部淋巴结结核的患者27例,准确率67.5%;CT诊断颈部淋巴结结核的患者28例,准确率70.0%;超声检查与CT扫描的诊断准确率差异无统计学意义（P>0.05）。两种方法联合诊断颈部淋巴结结核患者36例,准确率90.0%。结论颈部淋巴结结核的彩色多普勒超声声像图和多层螺旋CT影像表现均具有一定的特征性。CT扫描对颈部淋巴结结核诊断准确率略高于超声检查,超声联合CT增强扫描可明显提高颈部淋巴结结核诊断准确率。

关键词: 彩色多普勒超声, 多层螺旋CT扫描, 颈部淋巴结结核, 影像表现, 病理学诊断

Abstract: Objective To compare the two methods of Color Doppler Ultrasonography and Multi-slice Computed Tomography scans in the diagnosis of cervical lymph node tuberculosis. Methods Forty patients diagnosed with cervical lymph node tuberculosis which confirmed by pathology from January 2014 to December 2016 in Shenzhen Center for Chronic Disease Control and Shenzhen third people's hospital were selected as the research objects. And the patients were both diagnosed with Color Doppler Ultrasonography and Multi-slice Computed Tomography scans at the same time. All patients' imaging features were retrospectively analyzed. Accuracy rate of cervical lymph node tuberculosis and imaging findings of the two methods were compared. The sensitivity, concordance rate and kappa value of the two methods were calculated. Results In 40 patients, 27 cases with cervical lymph node tuberculosis were diagnosed by the Color Doppler Ultrasonography, which accounted for 67.5% of all patient; and 28 cases were confirmed by Multi-slice Computed Tomography scans, which accounted for 70.0%. The difference of two methods showed no statistical significance（P﹥0.05). The accuracy rate of the two approaches combined method was 90.0%. Conclusion Color Doppler Ultrasonography and Multi-slice Computed Tomography scans show distinguishable characteristics in the detection of cervical lymph node tuberculosis. Contrast-enhanced CT scanning has higher accuracy than Color Doppler Ultrasonography. Ultrasounography combined with enhanced CT scan can improve the accuracy of diagnosis of cervical lymph node tuberculosis obviously.

Key words: Color Doppler Ultrasonography, Multi-slice Computed Tomography, Cervical lymph node tuberculosis, Imaging features, Pathological diagnosis

郑秋婷, 董常峰, 陆普选, 陈晓芳, 罗婷婷, 乐晓华, 张芸, 刘俐. 彩色多普勒超声与多层螺旋CT扫描在颈部淋巴结结核诊断中的应用对比分析[J]. 新发传染病电子杂志, 2017, 2(4): 218-222.

ZHENG Qiu-ting, DONG Chang-feng, LU Pu-xuan, CHEN Xiao-fang, LUO Ting-ting, LE Xiao-hua, ZHANG Yun, LIU Li. The comparative analysis of Color Doppler Ultrasonography and Multi-slice CT scan in the diagnosis of cervical lymph node tuberculosis[J]. Electronic Journal of Emerging Infectious Diseases, 2017, 2(4): 218-222.

参考文献

[1] WHO, Global tuberculosis report 2016[R]. report 2016[R]. Switzerland: WHO, 2016.
[2] 李兰娟. 我国感染病的现状及防治策略[J].中华临床感染病杂志,2008,1(1):1-6.
[3] 朱巧贞. 加强肺外结核病的协作研究[J].中华结核和呼吸杂志,2008,31(2):81-82.
[4] 王雁,韦亚楠,齐金星,等.颈部淋巴结超声学分区[J].郑州大学学报(医学版),2015,50(1):143-146.
[5] Som PM, Curtin HD, Mancuso AA, et al.An imaging—basedclassification for the cervical nodes designed as an adjunct to recent clinically based nodal classifications[J]. Arch O–tolaryngol Head Neck surg, 1999, 125(4): 388-396.
[6] 方伟军,张晖,华蓉,等.颈部淋巴结结核的CT影像表现[J].现代医用影像学,2007,16(1):14-18.
[7] 徐启怀,王丰富,徐晓剑,等.颈部淋巴结结核的CT诊断和鉴别诊断[J].医学影像学杂志,2007,17(9):928-931.
[8] 罗明月,陈世林,赖丽莎,等.成人胸内淋巴结结核的多层CT表现与病理临床的关系[J].临床放射学杂志,2009,28(3):338-342.
[9] 任永芳,杨利霞,贾文霄. 颈部淋巴结结核的CT诊断[J]. 中国CT和MRI杂志,2010,8,(5):9-11.
[10] 张曾平. 颈部淋巴结结核的超声表现[J].临床医药文献杂志,2016,3(21):4250.
[11] 赵奕文,金正吉,郑颖,等.颈淋巴结结核的超声表现与分型[J].上海医学影像,2008,17(3):218–219.
[12] 张建芬,陈晓丽.颈淋巴结结核的超声表现[J].临床肺科杂志,2011,16(3):482.
[13] 文萍,肖秋金,刘蓓,等.彩色多普勒超声对颈部淋巴结结核的诊断及鉴别诊断[J].南昌大学学报(医学版),2011,51(9):70-72.
[14] 任永芳,李辉,陈洁,等.颈部淋巴结结核的影像诊断分析[J].临床误诊误治,2011,1(24):54-55.
[15] 杨洁. 颈部淋巴结病变的影像学诊断进展[J].实用放射学杂志,2008,10(24):1421-1424.
[16] 高立霓,刘秉彦,莫泽来.彩色多普勒超声诊断颈部淋巴结结核的临床价值[J].海南医学,2017,28(1):102-104.