高分辨率超声在浅表器官病变鉴别诊断中的应用研究

摘要：目的：探讨HRUS在浅表器官病变鉴别诊断中的应用价值、证据基础及临床局限。方法：以“高分辨率超声、浅表器官病变、甲状腺结节、乳腺病变、浅表淋巴结、涎腺肿瘤、软组织肿物、弹性成像、超声造影、人工智能”等为中文检索词，以“high-resolution ultrasound，superficial organ lesions，thyroid nodules，breast lesions，lymph nodes，salivary gland tumors，soft tissue masses，elastography，contrast-enhanced ultrasound，artificial intelligence”等为英文检索词，检索国内外指南、共识、综述及临床研究文献，围绕HRUS技术基础、器官应用、影像学比较、研究质量及局限性进行叙述性综述。结果：HRUS可较清晰地显示浅表病变的形态、边界、内部回声、钙化、血流及与周围组织关系，在甲状腺、乳腺、浅表淋巴结、涎腺及皮下软组织病变中均具有较高应用价值。联合弹性成像、超声造影及人工智能后，可在一定程度上提高风险分层和良恶性鉴别能力，但现有研究仍存在单中心研究较多、样本量差异较大、随访时间不足、操作者依赖性明显及参数标准不统一等问题。结论：HRUS是浅表器官病变首选或重要的一线影像学工具，但其诊断价值不应被简单等同于“单项超声征象判断”。未来需在规范扫查、统一报告、强化多模态联合和多中心验证的基础上，进一步明确HRUS在不同浅表器官疾病诊疗流程中的定位。

关键词：高分辨率超声；浅表器官病变；鉴别诊断

Application of High-Resolution Ultrasound in the Differential Diagnosis of Superficial Organ Lesions

Abstract: Objective: This paper explores the application value, evidence basis and clinical limitations of HRUS in the differential diagnosis of superficial organ lesions. Methods: Using “high-resolution ultrasound, superficial organ lesions, thyroid nodules, breast lesions, superficial lymph nodes, salivary gland tumors, soft tissue masses, elastography, contrast-enhanced ultrasound, artificial intelligence” as Chinese search terms, and “high-resolution ultrasound, superficial organ lesions, thyroid nodules, breast lesions, lymph nodes, salivary gland tumors, soft tissue masses, elastography, contrast-enhanced ultrasound, artificial intelligence” as English search terms, we retrieved domestic and foreign guidelines, consensus, reviews and clinical research literature. A narrative review was conducted focusing on the technical basis of HRUS, organ application, imaging comparison, research quality and limitations. Results: HRUS can clearly display the morphology, boundaries, internal echoes, calcification, blood flow and relationship with surrounding tissues of superficial lesions. It has high application value in thyroid, breast, superficial lymph nodes, salivary glands and subcutaneous soft tissue lesions. After combining with elastography, contrast-enhanced ultrasound and artificial intelligence, the risk stratification and benign/malignant differentiation ability can be improved to a certain extent. However, the existing studies still have problems such as more single-center studies, large sample size differences, insufficient follow-up time, obvious operator dependence and inconsistent parameter standards. Conclusion: HRUS is the preferred or important first-line imaging tool for superficial organ lesions, but its diagnostic value should not be simply equated with “single ultrasound sign judgment”. In the future, based on standard scanning, unified reporting, strengthening multimodal combination and multi-center verification, the positioning of HRUS in the diagnosis and treatment process of different superficial organ diseases should be further clarified.

Keywords: High-resolution ultrasound; Superficial organ lesions; Differential diagnosis

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