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Objective To discuss the ultrasound differentiation value of benign and malignant superficial tumescent lymph nodes.
Methods The L/S ratio，interior echo，CDFI and PWD frequency spectrum feature of the superficial lymph nodes in 46 patients’120 nodes were studied with color Doppler ultrasound.
Results The L/S ratio of the two groups including benign and malignant superficial lymph nodes were 2.09±0.22，1.56±0.27，medullary truncus arteriosus Vmax were 19.52±13.36cm/s，27.56±15.27cm/s，Vmin were 7.98±4.48cm/s，6.35±386cm/s and RI were 0.59±0.13，0.77±0.11 respectively.It has obvious differences of the two quotas of the L/S ratio and RI (P＜0105).Interior echo of benign tumescent lymph nodes displayed wider and brighter of the medulla and narrow of the cortices，but the malignant tumescent lymph nodes were on the contrary.CDFI showed the blood flow of the most benign tumescent lymph nodes displayed more abundant and regular，and the blood flow of most malignant lymph nodes displayed disorder and irregular.
Conclusion The L/S ratio，interior echo，CDFI and PWD frequency spectrum feature identification and diagnosis of the superficial benign and malignant lymph nodes has its edges possibly being the first trial method.
【Key words】 ultrasound superficial lymph nodes color Doppler flow imaging pulsed-wave Doppler quality identification
浅表淋巴结是指位于体表深筋膜层、距离皮肤3.0cm以内的淋巴结群。淋巴结病变往往是局部和全身疾病的反应。浅表淋巴结(头颈、腋窝、锁骨上窝及腹股沟 区)是诊断恶性肿瘤分期、制定治疗计划和分析疗效的重要依据。笔者对46例浅表淋巴结肿大患者进行了超声扫查，现报告如下。
1 资料与方法
1.1 一般资料 选择自2002年12月～2005年4月于我院因浅表淋巴结肿大就诊患者46例，男25例，女21例，年龄5～75岁，平均46.1岁，共检出颈部、腋窝及腹股沟部淋巴结120个。引起淋巴结肿大病因分别为：下肢淋巴管炎(5例)，颈淋巴结炎(10例)，颈化脓性淋巴结炎(4例)，颈淋巴结结核(3例)， 恶性淋巴瘤(6例)，转移性淋巴结病变(18例)。其中恶性淋巴瘤、转移性淋巴结、淋巴结结核、化脓性炎症经穿刺或手术病理证实；其余病例经抗感染治疗，追踪观察3个月后治愈而确诊。
1.2 仪器与方法 采用ACUSON XP10及Philips HDI5000型彩色多普勒超声诊断仪。超宽频探头频率5～10MHz，具有局部图像放大功能，放大后图像质量不减低。声束与血流夹角＜60°，超声观察深度3～6cm。患者取平卧位，充分暴露被检部位，如头颈、腋下、腹股沟等表浅易触摸部位，进行直接扫查。对相应病变部位淋巴结进行多切面扫查，然后局部放大，测量淋巴结纵径(L)和横径(S)，计算L/S值。观察淋巴结内部回声，采用彩色多普勒血流图(CDFI)观察淋巴结内及周边血流情况，采用脉冲多普勒(PWD)测量淋巴结门髓质主干动脉收缩期血流速度(Vmax)、舒张期末血流速度(Vmin)及阻力指数(RI)。
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