高频超声下不同类型颈部肿大淋巴结分区规律研究

doi:10.11904/j.issn.1002-3070.2019.05.012

摘要/Abstract

摘要： 目的探讨高频超声下转移性淋巴结及其他常见颈部淋巴结疾病在颈淋巴结解剖分区中的分布规律。方法回顾性分析2016年9月—2017年9月共547例颈部肿大淋巴结资料,根据病理结果分为非特异性淋巴结炎、淋巴结结核、淋巴瘤、转移性淋巴结四类,记录淋巴结常规超声参数及其在颈部淋巴结解剖分区中的分布。结果不同颈部淋巴结疾病在颈部淋巴结解剖分区中的分布状态不同。头颈部肿瘤的颈部淋巴结转移多分布于Ⅱ(62.00%)、Ⅲ(54.00%)及Ⅳ区(53.00%),锁骨下原发肿瘤的颈部淋巴结转移主要分布于Ⅴ(72.56%)、Ⅳ区(34.15%)。对特定肿瘤而言,还存在淋巴结转移的高危区域。结论超声检查可显示淋巴结疾病在颈部解剖分区中的分布情况。术前明确淋巴结疾病在解剖分区中的分布规律,可为临床的诊疗、手术术式及清扫范围提供更精确的依据。

关键词: 超声, 淋巴结, 颈部解剖分区

Abstract: Objective The aim of this study was to investigate the distribution of metastatic lymph nodes and other common lymph node in the neck anatomy of high frequency ultrasound.Methods A retrospective analysis of 547 cases of neck lymph nodes from September 2016 to September 2017 was performed.According to the pathological results,it was divided into non-specific lymphadenitis,lymph node tuberculosis,lymphoma and metastatic lymph nodes.The routine ultrasound parameters of lymph nodes and its distribution in the anatomical section of the neck lymph nodes were recorded.Results The distribution of different neck lymph node diseases in the anatomical section of the neck lymph nodes was different.The neck lymph node metastasis of head and neck tumors was mostly distributed in Ⅱ(62.00%),Ⅲ(54.00%)and Ⅳ areas(53.00%).The neck lymph node metastasis of primary subclavian tumors was mainly distributed in Ⅴ(72.56%)and Ⅳ areas(34.15%).For specific tumors,there were also high risk area of lymph node metastasis.Conclusion Ultrasound can show the distribution of lymph nodes disease in the anatomical section of the neck.Preoperatively clear the distribution of lymph node disease in the anatomical zone can provide a more accurate basis for clinical diagnosis,surgical operation and cleaning range.

Key words: Ultrasonography, Lymph node, Neck node levels

中图分类号:

R445.1

尚海涛, 董婧, 吴博林, 程文. 高频超声下不同类型颈部肿大淋巴结分区规律研究[J]. 实用肿瘤学杂志, 2019, 33(5): 447-450.

SHANG Haitao, DONG Jing, WU Bolin, CHENG Wen. Study on the zoning of different types of neck lymph nodes under high frequency ultrasound[J]. Journal of Practical Oncology, 2019, 33(5): 447-450.

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链接本文: http://journal09.magtechjournal.com/Jwk3_syzlxzz/CN/10.11904/j.issn.1002-3070.2019.05.012

http://journal09.magtechjournal.com/Jwk3_syzlxzz/CN/Y2019/V33/I5/447

参考文献

1 Lenghel LM,Botar Jid C,Bolboaca SD,et al.Comparative study of three sonoelastographic scores for differentiation between benign and malignant cervical lymph nodes[J].Eur J Radiol,2015,84(6):1075-1082.
2 Raja Lakshmi C,Sudhakara Rao M,Ravikiran A,et al.Evaluation of reliability of ultrasonographic parameters in differentiating benign and metastatic cervical group of lymph nodes[J].ISRN Otolaryngol,2014,2014(238740):238740.
3 Pisello F,Geraci G,Lo Nigro C,et al.Neck node dissection in thyroid cancer.A review[J].G Chir,2010,31(3):112-118.
4 王雁,韦亚楠,齐金星,等.颈部淋巴结超声学分区[J].郑州大学学报(医学版),2015,50(1):143-146.
5 Imani Moghaddam M,Davachi B,Mostaan LV,et al.Evaluation of the sonographic features of metastatic cervical lymph nodes in patients with head and neck malignancy[J].J Craniofac Surg,2011,22(6):2179-2184.
6 袁大光,那丽莉,邬晓明,等.超声在头颈部恶性肿瘤颈部淋巴结转移的诊断价值[J].实用肿瘤学杂志,2006,20(2):127-128.
7 Ryoo I,Suh S,Lee YH,et al.Comparison of ultrasonographic findings of biopsy-proven tuberculous lymphadenitis and kikuchi disease[J].Korean J Radiol,16(4):767-775.
8 Tachibana T,Orita Y,Fujisawa M,et al.Factors that make it difficult to diagnose cervical tuberculous lymphadenitis[J].J Infect Chemother,2013,19(6):1015-1020.
9 Guo W,Zhang L,Ji J,et al.Breast cancer sentinel lymph node mapping using near-infrared guided indocyanine green in comparison with blue dye[J].Tumour Biol,2014,35(4):3073-3078.
10 Rowe ME,Ozbek U,Machado RA,et al.The prevalence of extranodal extension in papillary thyroid cancer based on the size of the metastatic node:Adverse histologic features are not limited to larger lymph nodes[J].Endocr Pathol,2018,29(1):80-85.
11 Zhan WW,Zhou P,Zhou JQ,et al.Differences in sonographic features of papillary thyroid carcinoma between neck lymph node metastatic and nonmetastatic groups[J].J Ultrasound Med,2012,31(6):915-920.
12 郭笑寒,屈先凤,田兴仓,等.鼻咽癌颈部淋巴结转移的分布特征分析[J].中国医学影像技术,2016,32(2):209-213.
13 Lapeyre M,Miroir J,Biau J.delineation of the lymph nodes for head neck cancers[J].Cancer Radiother,2014,18(5/6):572-576.

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