颈部淋巴结病变CT灌注成像

CT Perfusion Imaging of Cervical Lymph Nodes

目的探讨CT灌注在区分颈部淋巴结病变中的临床价值。资料与方法对51例颈部淋巴结病变患者行CT灌注成像,包括淋巴瘤9例,甲状腺癌转移9例,甲状腺癌外的其他头颈鳞癌转移22例,淋巴结炎8例,结核3例。分析和比较不同病理类型淋巴结病变曲线和灌注参数特点。结果不同病理类型淋巴结病变CT灌注曲线(TDC)走势不同,淋巴结转移瘤以"速升速降"型为主,淋巴瘤TDC曲线低平,而慢性淋巴结炎以低平和缓升型为主。甲状腺癌转移淋巴结高灌注(PF)(127.04±65.78)ml.100g-1.min-1,淋巴瘤为低灌注(PF)(32.1±20.9)ml.100g-1.min-1,与淋巴结炎、其他头颈鳞癌转移瘤之间(PF)差异有统计学意义。结论不同病理类型的恶性淋巴结的TDC走势和灌注特点不同,利用CT灌注结合CT形态学表现可以帮助区分不同病理类型的淋巴结。

Objective To discuss the CT perfusion imaging features of various cervical lymph nodes, and to evaluate their clinic values in the differential diagnosis. Materials and Methods Dynamic enhanced CT scanning was performed in 51 patients with enlarged lymph nodes, including 9 patients with thyroid carcinoma Metastases, 22 patients with the other metastases of head and neck （expect thyroid carcinoma） , 9 patients with malignant lymphomas ,8 patients with lymphadenitis and 3 patients with tuberculosis. The time-density curve （ TDC ） and the data of their perfusion parameters were recorded and analyzed statistically. Results （ 1 ） The TDC of CT perfusion imaging could be classified into 3 types. The TDC of the metastases presented the type with rapid ascending and rapid descending after injecting contrast. The TDC of 6/9 （ 66.7% ） malignant lymphomas and chronic lymphadenitis showed low level curve. （ 2 ） The PF of thyroid carcinoma metastasis was PF （127.04 ±65.78） ml.100g^-1.min^-1, which was higher than that of the others. The PF of lymphomas was PF （32.1 ±20.9） ml.100g^-1.min^-1, which was lower than that of the others. There was significantly difference in the parameters of CT perfusion among the various lymph nodes. Conclusion The TDC and the parameters of CT perfusion among the various lymph nodes have some characteristic, it is useful to diagnose the lymph nodal diseases.