胰周淋巴结结核的CT及MRI诊断价值

Evaluation of CT and MRI in Diagnosing Tuberculosis of Peripancreatic Lymph Nodes

目的:探讨胰周淋巴结结核的CT及MRI表现及其诊断价值。方法:回顾性分析11例经组织学检查或临床追踪证实为胰周淋巴结结核的临床资料。结果:11例CT平扫中4例表现为胰周软组织密度的淋巴结肿大;5例表现为胰头区软组织肿块影;2例表现为淋巴结钙化。增强扫描4例胰周的淋巴结肿大呈环形强化,5例平扫示胰头区病灶为多个淋巴结彼此融合而成,环形强化的淋巴结形成多房样征象;2例淋巴结钙化的病灶表现为无强化。3例MRI平扫示胰头区软组织肿块影,T1WI呈稍低信号,T2WI上呈稍高信号,增强扫描时呈多房样强化。8例合并腹内脏器结核,8例合并肺结核。结论:平扫呈软组织密度的淋巴结肿大或淋巴结钙化,增强扫描病灶呈环形强化或多房样强化是胰周淋巴结结核的最常见的征象,影像学表现比较有特异性。

Objective： To study the manifestations and diagnostic value of CT and MR/ in the tuberculosis of peripancreatic lymph nodes. Methods： The clinical data of 11 patients with peripancreatic tuberculous lymphadenitis confh＇med by histological examination and followed-up were analyzed retrospectively. Results： Peripancreatic lymph node which displayed on CT as soft tissue density shadow were enlarged in 4 cases. CT scan revealed a mass in the region of the pancreatic head in 5 cases, calcifications of lymph nodes in 2cases. Enhanced CT findings： ring-like enhancement of hypertrophied lymph nodes was found at the peripancreatic area. In 4 cases, the lesion composed of several lymph nodes with honeycomb enhancement was located at the head of the pancreas in 5 cases, no enhancement in 2 cases. Peripancreafic MR/ showed soft tissue mass shadow in 3 patients. Lesions are slightly hypointensity on Tl-weighted images, slightly hyperintensity on T2-weighted images. Enhanced MRI demonstrated multilocular enhancement. 8 cases companied with abdominal organ tuberculosis and 8 patients suffered from lung tuberculosis. Conclusion： CT and MR/ findings of most tuberculosis of peripancreatic lymph nodes had characteristic features. Ring-like enhancement, multilocular sign and calcification of lymph nodes may suggest the diagnosis.