摘要
目的探讨剪切波弹性成像(SWE)联合超微血管成像(SMI)在鉴别诊断转移性淋巴结与淋巴瘤中的实际应用价值。方法选取2022年1月至2024年12月泰州市人民医院162例患者(218枚颈部淋巴结),术前均行SWE与SMI检查。SWE测量弹性模量参数(Emax、Emin、Emean、SD),SMI分析血管分型(Ⅰ型:门部主干型;Ⅱ型:弥漫树枝状;Ⅲ型:杂乱短棒状)及血管指数(Ⅵ)。以病理结果为金标准,比较单一技术与联合诊断模型的效能。结果SWE参数:转移组Emax(32.4±6.1 kPa)显著高于淋巴瘤组(15.6±2.8 kPa),且转移组SD值(8.9±2.1)更高(均P<0.01),反映其内部异质性。SMI分型:淋巴瘤组以Ⅱ型血管(弥漫树枝状)为主(82.5%),转移组以Ⅲ型(杂乱短棒状)为主(76.5%),良性组多为I型(P<0.01)。联合诊断效能:SWE联合SMI模型的敏感度(96.5%)、准确率(94.0%)及AUC值(0.963)均显著优于单一技术(SMI AUC=0.857;SWE AUC=0.831,P<0.05)。结论SWE与SMI联合技术通过量化组织硬度和微血管特征,突破传统形态学局限,为转移性淋巴结与淋巴瘤的无创鉴别提供高精度诊断工具,具有重要的临床转化价值。
Objective To evaluate the clinical utility of shear wave elastography(SWE)combined with superb microvascular imaging(SMI)in differentiating metastatic lymph nodes from lymphoma.Methods A total of 162 patients(218 cervical lymph nodes)admitted to Taizhou People’s Hospital from January 2022 to December 2024 were prospectively enrolled.All underwent preoperative SWE and SMI examinations.SWE measured elasticity parameters(Emax,Emin,Emean,SD),while SMI assessed vascular patterns(Type Ⅰ:hilar vascularity;Type Ⅱ:diffuse branching;Type Ⅲ:disorganized short vessels)and vascular index(Ⅵ).Pathological results served as the gold standard to compare the diagnostic performance of individual and combined techniques.Results 1)SWE parameters:The metastatic group showed significantly higher Emax(32.4±6.1 kPa vs.15.6±2.8 kPa,P<0.01)and SD(8.9±2.1,P<0.01),reflecting greater tissue heterogeneity.2)SMI patterns:Lymphoma predominantly exhibited Type Ⅱ vessels(82.5%),metastatic nodes displayed Type Ⅲ(76.5%),and benign nodes were mostly Type Ⅰ(P<0.01).3)Combined diagnostic efficacy:The SWE-SMI model achieved superior sensitivity(96.5%),accuracy(94.0%),and AUC(0.963)compared to standalone SMI(AUC=0.857)or SWE(AUC=0.831,P<0.05).Conclusion The integration of SWE and SMI overcomes limitations of conventional morphology by quantifying tissue stiffness and microvascular features,offering a high-accuracy noninvasive tool for distinguishing metastatic lymph nodes from lymphoma,with significant clinical translational value.
作者
印汪晨
尹明
YIN Wang-chen;YIN Ming(Yangzhou University,Yangzhou Jiangsu 225000,China)
出处
《泰州职业技术学院学报》
2025年第4期74-77,共4页
Journal of Taizhou Polytechnic College
关键词
剪切波弹性成像
超微血管成像
转移性淋巴结
淋巴瘤
shear wave elastography
superb microvascular imaging
metastatic lymph nodes
lymphoma
