中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2025, Vol. 23 ›› Issue (3): 253-257.doi: 10.19438/j.cjoms.2025.03.007

• 论著 • 上一篇    下一篇

超声造影在颈部淋巴结结核与口腔颌面部鳞癌颈部转移性淋巴结鉴别诊断中的价值

舒雪怡1,2, 贾芳3, 伊丽姆努尔·库尔班1,2, 买买提吐逊·吐尔地1,2   

  1. 1.新疆医科大学第一附属医院（附属口腔医院） 口腔颌面创伤正颌外科,新疆 乌鲁木齐 830054;
    2.新疆维吾尔自治区口腔医学研究所,新疆 乌鲁木齐 830054;
    3.新疆医科大学第一附属医院 腹部超声诊断科,新疆 乌鲁木齐 830054
  • 收稿日期:2024-11-07 修回日期:2025-01-05 出版日期:2025-05-20 发布日期:2025-06-05
  • 通讯作者: 买买提吐逊·吐尔地,E-mail: maimaitituxun@aliyun.com
  • 作者简介:舒雪怡（1997-）,女,在读硕士研究生,E-mail: 1505981873@qq.com
  • 基金资助:
    国家自然科学基金（82360198）

The Value of ultrasonography in the differential diagnosis of cervical lymph node tuberculosis and cervical metastatic lymph nodes of squamous carcinoma of the oral and maxillofacial region

Shu Xueyi1,2, Jia Fang3, Yilimunuer Kuerban1,2, Maimaitituxun Tuerdi1,2   

  1. 1. Department of Oral and Maxillofacial Trauma and Orthognathic Surgery, First Affiliated Hospital Stomatological Hospital of Xinjiang Medical University. Urumqi 830054;
    2. Institute of Stomatology, Xinjiang Uygur Autonomous Region. Urumqi 830054;
    3. Department of Abdominal Ultrasound, First Affiliated Hospital of Xinjiang Medical University. Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Received:2024-11-07 Revised:2025-01-05 Online:2025-05-20 Published:2025-06-05

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摘要： 目的：探讨超声造影（contrast-enhanced ultrasound,CEUS）在颈部淋巴结结核与口腔颌面部鳞癌颈部转移性淋巴结鉴别诊断中的价值。方法：回顾分析在新疆医科大学第一附属医院就诊并行颈淋巴结清扫术的38例（55枚淋巴结）颈部淋巴结肿大患者的超声检查资料,根据病理结果分为结核组（n=27）和转移组（n=28）,比较2组的常规超声及超声造影影像特征。采用SPSS 25.0软件包对数据进行统计学分析。结果：结核组与转移组在边界、形态、淋巴门结构、内部回声、是否有液化或钙化区的比较均无统计学差异（P>0.05）。结核组与转移组的灌注模式及灌注类型比较,差异有统计学意义（P<0.05）;结核组主要灌注模式为离心性灌注,而转移组主要为向心性灌注。灌注类型中结核组以Ⅱ型（呈现规则灌注缺损的非均匀增强或环形增强）为主,转移以Ⅲ型（呈现不规则灌注缺损的非均匀增强）为主。结论：与传统超声检查相比,超声造影技术在临床上对于鉴别颈部淋巴结结核和口腔颌面部鳞状细胞癌颈部转移性淋巴结具有更高的诊断价值。

关键词: 超声造影, 颈部淋巴结结核, 口腔颌面部鳞状细胞癌, 转移性淋巴结, 诊断价值

Abstract: PURPOSE: To investigate the value of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of cervical lymph node tuberculosis and oral and maxillofacial squamous cell carcinoma with cervical lymph node metastases. METHODS: The ultrasonographic data of 38 patients(55 abnormal lymph nodes) with enlarged cervical lymph nodes who presented to First Affiliated Hospital of Xinjiang Medical University and underwent neck dissection were categorized into tuberculosis group(n=27) and metastatic(n=28) group according to the pathological results, and the imaging characteristics of conventional imaging and CEUS were compared. SPSS 25.0 software package was used for data analysis. RESULTS: The differences between the tuberculosis and metastasis group in terms of boundaries, morphology, lymphatic portal structures, internal echoes, and the presence of liquefied and calcified areas were not statistically significant(P>0.05). A comparison of the pattern and type of perfusion between the two groups showed a statistically significant difference(P<0.05). Centrifugal perfusion was predominant in the tuberculosis group, whereas afferent perfusion was predominant in the metastatic group. Perfusion type was predominantly type Ⅱ in the tuberculosis group and type Ⅲ in the metastatic group. CONCLUSIONS: Compared with conventional ultrasonography, CEUS has a higher diagnostic value in identifying cervical lymph node tuberculosis and metastatic cervical lymph nodes of OSCC in clinical practice.

Key words: Ultrasonography, Cervical lymph node tuberculosis, Oral and maxillofacial squamous cell carcinoma, Metastatic lymph nodes, Diagnostic value

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