Role of Contrast-Enhanced Ultrasound (CEUS) in the Diagnosis of Cervical Lymph Node Metastasis in Nasopharyngeal Carcinoma (NPC) Patients
Role of Contrast-Enhanced Ultrasound (CEUS) in the Diagnosis of Cervical Lymph Node Metastasis in Nasopharyngeal Carcinoma (NPC) Patients
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DOI：
10.3389/fonc.2020.00972
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发表时间：
2020-07-17
影响因子：
4.7
通讯作者：
Luo, Yan
中科院分区：
文献类型：
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作者：
Ling, Wenwu;Nie, Ji;Luo, Yan
目的：探讨超声造影（CEUS）对鼻咽癌颈部淋巴结良恶性的诊断价值。材料与方法：对144例颈浅淋巴结肿大的鼻咽癌患者行CEUS检查。同时比较颈部良恶性淋巴结的CEUS图像特征。我们分析了时间-强度曲线（TIC）的参数，包括达峰时间（TP）、γ曲线下面积（AUC）和峰强度（PI）。同时采用受试者工作特征（ROC）曲线分析评价CEUS的诊断价值。结果：共行淋巴结检查144例，其中良性结节64例，转移性结节80例。良性结节绝大多数呈离心性灌注（96.88%，62/64），强化均匀（93.75%，60/64）;恶性结节绝大多数呈向心性灌注（92.50%，74/80），强化不均匀（80.00%）。定量分析显示，良性淋巴结的PI、TP和AUC等CEUS参数（分别为12.51 ± 2.15、23.79 ± 11.80和1110.33 ± 286.17）显著高于恶性淋巴结（分别为10.51 +/-2.98、16.52 +/-6.95和784.09 +/-340.24）。上述三个参数和CEUS图像特征的辅助将产生可接受的诊断价值。结论：CEUS的灌注模式和定量参数可为鼻咽癌患者颈部淋巴结的评价提供有价值的信息。
Objective:The aim of the study was to evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) in distinguishing between benign and malignant cervical lymph nodes in patients with nasopharyngeal carcinoma (NPC). Material and Methods:A total of 144 NPC patients with enlarged superficial cervical lymph nodes underwent CEUS examination. The comparison of CEUS image characteristics between malignant and benign cervical lymph nodes was performed in this study as well. We analyzed parameters of the time-intensity curve (TIC), which includes time to peak (TP), area under the gamma curve (AUC), and peak intensity (PI). Furthermore, receiver operating characteristic (ROC) curve analysis was also investigated to evaluate the diagnostic value of CEUS. Result:We conducted 144 lymph node examinations in total, where 64 cases were biopsy-proven benign nodules and 80 cases were biopsy-proven metastatic nodules. The vast majority of the benign nodes displayed centrifugal perfusion (96.88%, 62/64) and homogeneous enhancement (93.75%, 60/64), while most of the malignant nodes showed centripetal perfusion (92.50%, 74/80) and inhomogeneous 80.00% (64/80). In addition, quantitative analysis showed that CEUS parameters including PI, TP, and AUC in benign lymph nodes (12.51 +/- 2.15, 23.79 +/- 11.80, and 1110.33 +/- 286.17, respectively) were significantly higher than that in the malignant nodes (10.51 +/- 2.98, 16.52 +/- 6.95, and 784.09 +/- 340.24, respectively). The assistance of the three aforementioned parameters and CEUS image characteristics would result in an acceptable diagnostic value. Conclusion:Our results suggest that imaging perfusion patterns as well as quantitative parameters obtained from CEUS provide valuable information for the evaluation of cervical lymph nodes in NPC patients.