CT对胸片诊断右下气管旁区淋巴结肿大准确性的评估

Right- lower paratracheal lymphadenonectasis:chest radiograph findings correlation with CT

观察分析了１１４例患者肺后前（ＰＡ）位相右上纵隔淋巴结肿大的征象与ＣＴ所见的关系。淋巴结正常５８例，增大（直径＞１０ｍｍ）５６例。以下６项指标的准确性分别为：右气管旁线（ＲＰＳ）增宽８１％，其边波浪状６７％，奇静脉球增大６７．７％，上腔静脉（ＳＶＣ）轮廓凸起６８．２％，区密度增高７１．８％，ＳＶＣ外缘至气管内壁的距离增宽（＞２．２ｃｍ）６０．７％。若当上述６个征象中至少一个出现时定为阳性，肺ＰＡ位相发现淋巴结肿大４４例，敏感性最高，为８４．６％，特异性７７．８％，准确性８１．１％。淋巴结肿大组上述征象的阳性率明显高于正常组（ｘ￣２检验，Ｐ＜０．０１）。ＣＴ示肿大淋巴结在气管前、前外、外侧及后方４个位置中，好发于气管前外侧，这可解释肺后前位相的表现。

Possible signs of paratracheal lymphadenonectasis on the posteroilnterior chestradiography(PA) were assessed in 114 patients and correlated with computed tomogrdphy(CT). The nodes were normal in size in 58 patients and enlarged(≥10mm)in 56.The accuracy rates ofthe six signs were:widening of the right paratracheal stripe(RPS)was 81%,wave- like border ofRPS was 67.0%,enlargement of the azygos node was 70.5%,convex contour of the superior venacava(SVC)was 68.2%,increased density in the region of SVC was 71.8%,widening of the distancebetween lateral border of SVC and medial trachea was 60.7%。When at least one of the six ab-normal signs was present,it was given a positive diagnosis.Lymphadenonectasis could be detectedon the PA film in 44 patients,the sensitivity was 84.6%,specificity was 77.8%,accuracy was81.1%,the positive rate of these six signs in lymphadenonectasis group was higher than that ofnormal group(x￣2 test, P< 0.01).CT demonstrated that the enlarged nodes were anterolateralrather than anterior,lateral and posterior to the trachea. confirming the finding on the PAradiography.