颈部淋巴结结核的CT表现

CT findings of the cervical tuberculous lymphadenitis(CTBL)

目的探讨颈部淋巴结结核的CT影像表现及评价CT检查对颈部淋巴结结核疾病的诊断价值。方法搜集经病理证实的淋巴结结核25例,其中女17例,男8例,全部病例均行CT增强扫描。结果25例均为多个淋巴结同时受累(100%),以中下颈部及颈后三角区受累最常见,IV区+锁骨上区占84%,V区占60%。CT增强扫描分4型:1型:均匀强化;2型:薄环状强化;3型:花环状强化;4型:不均匀强化。各种增强类型可同时存在,二种及二种以上增强类型同时存在占80%,淋巴结融合占84%。结论CT增强检查能清楚显示颈部淋巴结结核病变的数目、部位、形态及周围结构关系,多种增强类型同时存在反映不同时期病理改变同时存在。

Objective To investigate the CT findings of the cervical tuberculous lymphadenitis （CTBL）, and to evaluate the value of CT in demonstrating the cervical tuberculous lymphadenitis. Methods Twenty-five cases of tuberculous lymphadenitis confirmed by pathologically, including 17 women and 8 men, underwent enhanced CT scan. Results Multiple lymph nodes were involved in all cases. Among 84% of all cases, the inferier internal jugular and supraclavicular lymph nodes were involved, and in 60% of cases, the posterior triangle lymph nodes were involved by CTBL. The enhanced patterns on CT scan were divided into four types： Type 1： Iso-density enhancement; Type 2： Thin rim enhancement; Type 3： Corolla-like enhancement; Type 4： Heterogeneous enhancement. Two and more enhanced types were both existed in 80% of cases, lymph nodes blended in 84% of cases. Conclusion CT can well demonstrate the number, location, shape, surrounding structure and enhancement features of CTBL. These various CT patterns reflect the complete spectrum of node pathology.