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Objective: To observe the sonographic features of superficial lymph node lesions in non-Hodgkin's lymphoma and its hemodynamic performance comparison NHL (non-Hodgkin lymphoma, NHL) International work typing (international working formulation, is, the IWF, 1982) low grade, lymph node ultrasound characteristics in highly malignant group, and after treatment residual lymph node ultrasound characteristics of PET / CT imaging characteristics, and to explore the clinical value of ultrasound in the diagnosis and efficacy evaluation of non-Hodgkin's lymphoma. Methods: In our hospital first diagnosed by pathological examination diagnosed 57 cases of non-Hodgkin's lymphoma patients, including 35 males and 22 females, aged 15 to 83 years, an average of (48 ± 12) years of age. (15 cases for low-grade malignant lymphoma, 8 males and 7 females; 42 cases of high-grade lymphoma, 27 males and 15 females) were observed superficial lymph nodes 179. U.S. company GE Logiq9 color Doppler ultrasonic diagnostic apparatus, linear probe, frequency 7 ~ 12MHZ. Inspection time in more than 20 minutes at a time, to ensure that no omissions. The patient was supine, the probe neck, armpits, groin lymph node the observation records lymph nodes position, number, shape, echo, the size, the maximum section measuring long diameter (L) and short axis (S) L / S. Color Doppler flow imaging (CDFI) and color Doppler energy (DPI) to observe the type of lymph node blood supply. Pulse Doppler (PWD) measurements lymph Gate District artery peak systolic velocity (Vmax) and end-diastolic peak flow velocity (Vmin) and calculate the resistance index (RI), pulsation index (PI). The PWD sample line angle lt; 60 °, all three values ??are measured spectrum averaged. All patients were law accept CHOP (cyclophosphamide, adriamycin, vinblastine, prednisone) or COP (cyclophosphamide, vinblastine, prednisone) combination chemotherapy regimens track observed in all cases, check and store the image before and after each treatment, the end of the 57 patients with chemotherapy after, there are still 32 patients with 77 residual lymph node in which patients were 19 males and 13 females, aged 15 to 76 years, an average of (45 ± 11) years of age. Select last chemotherapy after four weeks, with residual lymph nodes in patients with ultrasound again, while PET / CT scan done in our hospital (17 cases) or hospital (15 cases). Residual lymph node in common contrast observed after treatment. The combination of patients with pathological examination again the results were compared. These results do statistical analysis, to investigate its clinical value. Result: a two-dimensional sonographic NHL lymph plump, oval-type or nearly round, low or very low echo, cortical thickening, lymph door not eccentric, low-grade malignant lymphoma lymph nodes showed scattered distribution no harmony phenomenon, in highly malignant lymphoma, 10 cases, 36 lymph nodes, there is fusion phenomenon. Liquefaction necrosis phenomenon is not obvious in the NHL lymph nodes, only 1 case. Showed no calcification within the lymph nodes of all cases. Low grade L / S than in the high-grade group, the significant difference is statistically significant (P lt; 0.05). Hemodynamic performance of low-grade group Mun District artery RI and PI compared with the highly malignant group, a significant difference was statistically significant (P lt; 0.05). Blood flow velocity between the two groups of lymph nodes Vmax Vmin compare the difference is not significant, no significant differences (P gt; 0.05). 3 blood flow distribution performance according to the lymph nodes the CDFI and DPI blood flow, the type of the blood supply of the lymph nodes in 4-type, no-flow type: exploration and flow signals were not using CDFI and DPI; center: lymph door at visible short linear or rod-like blood flow signal; center abundant type: blood flow from the lymph door to enter, was the root branch-like distribution, almost fills the entire lymph node; peripheral type: only visible in the lymph nodes surrounding the thin wire-like or star spotting blood flow signal. NHL lymph nodes in the blood supply in this study, the main center type and center-rich. Low grade center blood type for more, accounted for 56.2% (27/48), in the highly malignant group center rich more common, accounting for 54.2% (71/131). Blood flow and peripheral blood supply in the two groups of lymph nodes are rare. Significant differences between the two sets of blood for type was statistically significant (P lt; 0.05). After the end of chemotherapy, 77 lymph nodes ultrasound to determine residual tumor pathology or clinical results 73 (94.8%). PET / CT judge the situation 75 (97.4%), consistent with the pathology or clinical results. Two methods suggest that the residual tumor group with different metabolic and hemodynamic characteristics of tumor residual lymph nodes. The ultrasound display positive group than negative lymph node diameter (L) / short diameter than the small (S), rich blood supply, blood flow faster, RI (P lt; 0.05). PET / CT examination showed residual tumor group lymph node in a high metabolic state, no residual tumor group lymph nodes abnormally high metabolism. The tumor residual lymph nodes echocardiography and PET / CT display a certain correlation between high metabolism. Conclusion: a different degree of malignancy of the NHL lymph morphological types of blood supply, blood flow parameters on the performance of different ultrasound can provide important clinical reference information. 2 high grade lymphoma course of the disease is relatively short, rapid progress, lymph node lymphocytes in malignant proliferation of fast, accumulate in the lymph node cortical sinus, and myeloid sinus, causing rapid lymph node swelling, caused by lymph node length diameter scaling. Therefore, the L / S value size to a certain extent reflect the lymphoma malignant degree, but there is a crossover phenomenon. The 3 vicious higher the degree of the NHL lymph blood supply is more abundant. RI, PI is a good indicator to reflect the organization peripheral hemodynamic status, its numerical lower prompts Organization peripheral vascular density and perfusion. It also prompts from the oncology perspective RI and PI may reflect the degree of malignancy of the lymphoma. 4 the tumor residual lymph node group ultrasound shows a rich blood supply and lower, RI, the high hemodynamic status and PET / CT showed higher SUV values, the organization is in a high metabolic state consistent. 5 no residual tumor group lymph flow signals, RI, which may be related to the chemotherapy drug acts directly on vascular endothelial cells caused tumor blood vessels become thin or occlusion related. 6 ultrasound and PET / CT examination in the treatment of NHL residual lymph node residual tumor judgment accuracy rates higher, the practical value of the important clinical treatment effect for clinical judgment. PET / CT scan is not yet universal, and expensive ultrasound as a routine examination of residual lymph nodes after lymphoma treatment.
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