CAJ | 학술논문

目的探讨彩色多普勒超声在淋巴结疾病的定性诊断价值．方法应用彩色多普勒超声观察93个肿大淋巴结的超声特征，是否伴“假肾征”、评定血流分级、测定阻力指数（RI）、最大流速（Vmax）、横径/纵径（L/D）．结果93个肿大淋巴结临床确诊病例中超声诊断恶性淋巴结疾病符合率86%，诊断良性淋巴结疾病符合率88%．4个病检为淋巴结核的患者因超声特征与恶性淋巴组相似故误诊为淋巴瘤，误诊率8%．增殖性淋巴结伴“假肾征”，93%血流分布为0～Ⅰ级．90%淋巴结炎伴“假肾征”，95%血流分级Ⅱ～Ⅲ级．恶性淋巴组无“假肾征”，86%血流分级为Ⅲ级．L/D比值、RI值良性淋巴组与恶性淋巴组比较有统计学意义（P＜0.01）．Vmax值增值性淋巴组与其他各组比较有统计学意义（P＜0.01）．结论各类淋巴疾病的病理特征决定了超声特征．“假肾征”、血流分级、RI值、Vmax值、L/D值结合临床资料能提高各类淋巴疾病的定性诊断准确率．
목적탐토채색다보륵초성재림파결질병적정성진단개치．방법응용채색다보륵초성관찰93개종대림파결적초성특정，시부반“가신정”、평정혈류분급、측정조력지수（RI）、최대류속（Vmax）、횡경/종경（L/D）．결과93개종대림파결림상학진병례중초성진단악성림파결질병부합솔86%，진단량성림파결질병부합솔88%．4개병검위림파결핵적환자인초성특정여악성림파조상사고오진위림파류，오진솔8%．증식성림파결반“가신정”，93%혈류분포위0～Ⅰ급．90%림파결염반“가신정”，95%혈류분급Ⅱ～Ⅲ급．악성림파조무“가신정”，86%혈류분급위Ⅲ급．L/D비치、RI치량성림파조여악성림파조비교유통계학의의（P＜0.01）．Vmax치증치성림파조여기타각조비교유통계학의의（P＜0.01）．결론각류림파질병적병리특정결정료초성특정．“가신정”、혈류분급、RI치、Vmax치、L/D치결합림상자료능제고각류림파질병적정성진단준학솔．
Objective To investigate the clinical value of Color Doppler Ultrasound in diagnosis of lymph node diseases. Methods We observed the ultrasound features of the 93 cases of swelled lymph nodes with Color Doppler ultrasound. The ultrasound features included pseudokidney sign, assessment on blood flow distribution, the Doppler resistive Index (RI), maximal flow rate (Vmax),the longitudinal axis compared to the diameter of a node (L/D ratio) . Results Out of 93 cases of clinically confirmed swelled lymph nodes,the concordance rate of Color Doppler Ultrasound was 86%and 88%in diagnosis of malignant lymph node disease and benign lymph node disease, respectively. 4 cases of lymph tuberculosis were misdiagnosed as lymphoma due to the similar ultrasound characteristics found in malignant lymph group,the rate of misdiagnosis was 8%. In the cases of proliferative lymph node diseases with Pseudokidney sign, 93% of the blood flow distribution was classified as grade 0-I. 90% of lymphadenitis were found with Pseudokidney sign,and 95%of those cases with blood flow distribution was classified as grade II-III. Malignant lymph diseases had no Pseudokidney sign, and 86%of blood flow distribution grade was as III. There was statistically significant difference in the L/D ratio and RI between benign lymph group and malignant lymph group (P<0.01) . There was statistically significant difference in Vmax between lymphoproliferative group and other groups (P<0.01) . Conclusions Pathological characteristics on different lymph node disease determin the ultrasound characteristics. Combined clinical data based on Pseudokidney sign, Blood Flow Distribution, RI value,Vmax value and L/D ratio can enhance the accuracy of various lymph node disease diagnosis.