彩色多普勒超声诊断浅表淋巴结结核的临床研究

Clinical significance of color doppler ultrasound in diagnosis of superficial lymph node tuberculosis

摘要:

目的 观察分析浅表淋巴结结核诊断中采用彩色多普勒超声的临床诊断意义。方法 选取2014 年 1 月—2018 年7 月宁波市医疗中心李惠利东部医院及宁波市镇海龙赛医院收治的70 例疑似浅表淋巴结结核 患者，分别行CT、彩色多普勒超声检查，均给予穿刺活检，以活检的病理学检查诊断为金标准。对照CT 与 彩色多普超声检查诊断的准确率、误诊率、漏诊率、检查费用，分析不同类型的浅表淋巴结结核的超声影 像学特点。结果 多普勒检查敏感性为97.14%（95% CI ：0.779，0.995），特异性为97.14%（95% CI ：0.779， 0.995）；CT 检查敏感性为88.57（95% CI ：0.647，0.952），特异性为88.57（95% CI ：0.647，0.952），且多普勒 检查费用低于对照组（P <0.05），并根据超声影像学表现给予临床分型。结论 对疑似浅表淋巴结结核的患者， 采用彩色多普勒超声检查，在减轻患者经济负担同时，可获得较高的诊断敏感性和特异性。根据其影像学的 特点，区分出不同的浅表淋巴结结核类型，可协助临床明确诊断，为治疗打下坚实基础。

Abstract:

Objective To observe the clinical diagnostic significance of color doppler ultrasound in the diagnosis of superficial lymph node tuberculosis. Methods A total of 70 cases of suspected superficial lymph node tuberculosis treated in Ningbo Medical Center Li Huili Eastern Hospital and Ningbo Zhenhailonglongsai Hospital (2014, 01-2018, 07). The diagnoses of 70 patients was performed by CT and color doppler ultrasound. The diagnostic accuracy of CT and color doppler ultrasound, the rate of misdiagnosis, the rate of missed diagnosis and the cost of examination were compared, and the ultrasonographic features of different types of superficial lymph node tuberculosis were analyzed. Results Sensitivity of doppler examination was 97.14 (0.779, 0.995), and specificity was 97.14 (0.779, 0.995); Sensitivity of CT examination was 88.57 (0.647, 0.952), and specificity was 88.57 (0.647, 0.952). The doppler examination cost was significantly lower than that of the control group, and the difference was statistically significant (P < 0.05). It can be classified according to the ultrasonographic findings. Conclusions The color doppler ultrasound examination for patients with suspected superficial lymph node tuberculosis can reduce the economic burden of the patients and obtain higher diagnostic sensitivity and specificity. According to the characteristics of the imaging, superficial lymph node tuberculosis can be easily divided into different types, which can help clinical diagnosis and treatment.