摘要
目的:分析成人纵隔淋巴结结核的多层螺旋CT(MSCT)特点以提高诊断水平。方法:回顾性分析经临床病理证实的42例成人纵隔型淋巴结结核的MSCT表现并进行总结。结果:①部位:42例CT共见淋巴结肿大185个,淋巴结主要位于4R区、2R区,8例累及1个区淋巴结,34例累及2个以上区;②大小:短轴直径范围10~54mm,加权平均(18±6)mm.长轴直径范围1O~68mm,加权平均(26±11)mm;③形态:37例进行病理对照的169个淋巴结中,122个(72.189%)未融合的淋巴结呈卵圆形或圆形,47个(27.811%)融合的淋巴结呈分叶状或不规则形;④边缘:122个(72.189%)未融合的淋巴结边缘光滑、清楚。47个(27.811%)淋巴结干酪样坏死,边缘欠清楚;⑤密度:145个(78.378%)淋巴结平扫密度基本均匀,CT值40~60HU。40个(21.622%)淋巴结平扫密度不均匀,中央部分CT值16~37HU,平均25.2HU;32个淋巴结内或周边有斑点状钙化。⑥增强表现:169个淋巴结表现为7种强化形式。a.均匀强化(12个);b.不均匀强化、中心低强化有小的低密度区(22个);C.周边不规则厚壁强化、中心无强化(52个);d.周边薄环状强化、中心无强化(36个).e.周边不规则强化、中心无强化区延伸至淋巴结外(4个);f.周边不规则环状强化、中心分隔状强化(40个);g.无明显强化(3个);⑦肺内结核:8例(19.048%)肺内有结核病灶,其中6例为非活动性条索状影及钙化灶,2例为斑片状活动性结核。结论:MSCT对成人纵隔淋巴结结核具有重要诊断价值。
Objective: To improve the diagnosis of adult mediastinal lymph tuberculosis by analysing the characteristics of multislice CT (MSCT). Methods: MSCT findings of 42 cases of adult-type mediastinal lymph node tuberculosis clinicopathological confirmed were retrospectively analysed and summed up. Results: ①Site: 185 swollen lymph nodes were found in 42 cases by CT , mainly in 4R, 2R district, of which 1 lymph node area was involved in 8 cases, more than 2 lymph nodes area were involved in 34 cases; ②Size:Short-axis diameter range 10 ~ 54 mm with the weighted average of 18 ~ 6mm, long-axis diameter range 10 ~ 68 mm with the weighted average of 26 ~ 11mm; ③Morphology:Of the 169 lymph nodesin 37 cases pathological confirmed, 122 (72.189%) were round or oval without integration, 47 (27.811%) integrated manifesting lobulated or irregu lar; ④Edge: 122 (72.189%) lymph nodes without integration were smooth and well-margined. 47 (27. 811~/00) lymph node with cheese necrosis manifested an obscure boundary. ⑤Density: Plain density of 145 (78.378 % ) lymph nodes was found ho mogenous, with the CT value of 40 ~ 60 HU,while that of another 40 (21. 622~) lymph nodes were inhomogenous, the central CT value was 16 ~ 37 HU, with an average of 25.2 HU;⑥Enhanced findings: 7 kinds of enhancement were found in 169 lymph nodes, a. homogenous enhancement (12); b.inhomogenous enchancement with small areas of low density in the center (22); c.peripheral enhancement with irregular thick wall , while the center area was unenhanced (52) ; d.peripheral enhance ment with thin annular wall,while the center area was unenhanced (36); e. irregular peripheral enhancement with the unen hanced central area extending to the outside of lymph nodes (4) ; f. irregular peripheral ring-like enhancement with the enhanced strip separating the center area(40) ; g. no significant enhancement (3) ;⑦Pulmonary tuberculosis:8 (19.048%) cases had pul monary tuberculosis, of which 6 had non-active cord-like lesions and calcified lesions, 2 had active tuberculosis patchy. Conclusion: MSCT is very valuable in diagnosis of adult mediastinal lymph node tuberculosis.
出处
《中国中西医结合影像学杂志》
2009年第3期175-178,共4页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
关键词
成人
肺门
纵隔
结核
淋巴结
体层摄影术
X线计算机
Adult
Hilar
Mediastinal
Tuberculosis, Lymph node
Tomography, X ray computed.