The Value Of Contrast-enhanced Ultrasound In The Diagnosis Of Cervical Tuberculous Lymphadenitis

Objective:To investigate the characteristics and the application value of contrast-enhanced ultrasound (CEUS) in diagnosis of cervical lymphoid tuberculosis.Methods:60 patients with cervical lymphoid tuberculosis. were examined by conventional ultrasound and contrast-enhanced ultrasound, and the location, shape, size, echo and enhanced intensity and mode were observed.Results:(1) There are three types:type â…  (homogeneous enhancement type), type â…¡ (heterogeneous enhancement type) and type â…¢ (no enhancement). And the type â…¡ is divided into A, B, C and D 4 subtypes. (2) Compared with conventional ultrasound, CEUS can reflect the internal necrosis of lymph nodes more objectively, so as to improve the detection rate of necrosis in the lymph nodes, and provide important basis for the diagnosis and treatment of the disease. (3) There was no significant correlation between the maximum section area of lymph node tuberculosis and the rate of lymph node necrosis. (r=-0.141, P=0.406), smaller lymph nodes may also have a higher rate of necrosis or even complete necrosis. (4) There are 31 lymph nodes tuberculosis with the maximum diameter is less than or equal to 20 mm, and 29 lymph nodes with the maximum diameter over 20mm, the group with less than 20 mm, the CEUS with enhanced mode of rim-like (20/31,64.5%), the group with over than 20mm, the CEUS enhancement mode mainly with uneven enhancement (14/29,48.3%), there was significant difference between the 2 groups (x2=6.782, p=0.034).Conclusions:The common manifestation of CEUS in cervical lymph nodes tuberculosis is the rim-like enhancement with edge and surrounding, which combine with central separated-like enhancement or honeycomb-like. Different size of cervical lymph node tuberculosis owns different CEUS performance. The group with the maximum diameter of less than 20 with ring like enhancement mostly, and the maximum diameter of>20 group mm is heterogeneous. Most of the lymph nodes with necrosis, however There was no significant correlation between necrosis rate and the lymph node size. The CEUS can objectively reflect the enhancement and necrosis of the cervical lymph node tuberculosis, and provide an objective basis for the diagnosis.