颈部浅表淋巴结反应性增生的超声表现

The Sonographic Appearance of Reactive Hyperplasia of Superficial Cervical Lymph Nodes

目的 探讨颈部浅表淋巴结反应性增生的超声表现.方法 2009年11月-2011年10月在健康查体人群中选取淋巴结反应性增生患者90例,采用彩色超声诊断仪,观察和测量淋巴结的位置、大小、形态、淋巴结门、内部回声、血流.结果 90例共检出颈部淋巴结反应性增生311个,单发34例,34个淋巴结;多发56例,277个淋巴结;单区域分布30例,多区域分布60例,分布区域依次为：Ⅰ区100个（占32.1%）,Ⅱ区92个（占29.6%）,Ⅲ区81个（占26.0%）,Ⅴ区28个（占9.0%）,Ⅳ区和Ⅵ区少见,共10个（占3.3%）.最大长径1.00～2.80 cm,短径0.26～1.10 cm,255个（占82.0%）淋巴结长径/短径≥2,皮质厚度（0.21±0.06）cm;皮质厚度与短径比值（0.34±0.15）;动脉收缩期速度（PSV）（7.6±1.3）cm/s,阻力指数（RI）（0.60±0.18）.多数呈椭圆形、梭形,部分呈类圆形,皮质增厚且均匀一致,回声减低,髓质呈强回声,皮、髓质分界清晰,淋巴门居中存在,包膜完整、纤细,与周围组织界限清晰.结论 超声检查颈部浅表淋巴结反应性增生声像图清晰、诊断准确,可作为首选方法在健康人群中进行淋巴结反应性增生的诊断和随访,以减少穿刺技术的应用.

Objective To investigate the sonographic appearance of reactive hyperplasia of superficial cervical lymph nodes. Methods A total of 90 health adults with reactive hyperplasia of superficial cervical lymph nodes who came to our hospital for regular physical examination were recruited from November 2009 to October 2011. Color Doppler ultrasound was used to exam- ine the location, size, shape, hilum, internal echo, blood flow of the lymph nodes with reactive hyperlasia. Results There were 311 lymph nodes with reactive hyperplasia detected. In 34 participants, the hyperplasia happened in solitary node; and in 56 participants, the hyperplasia happened in multiple nodes. In 30 cases, the nodes with hyperplasia were in single region; while in 60 cases, the nodes with hyperplasia were in multiple regions. A majority of the node with hyperplasia were located in I region （100 nodes, 32. 1% ）, followed by U region （92 nodes, 29. 6% ）, IH region （81 nodes, 26.0% ）, V region （28 nodes, 9.0% ） , 1V and V[ regions （a total of 10 nodes, 3.3% ） . The longest axes of the nodes ranged from 1. 00 cm to 2. 80 em, and the short axes ranged from 0.26 cm to 1.10 cm. The long axis/short axis ratio （L/S） was ≥2 in 255 nodes （ 82. 0% ）. The thickness of the cortex was （0. 21 ±0. 06） cm, with the thickness/short axis ratio of （0. 34 ±0. 15） . The peak arterial sys- tolic velocity was （ 7.6 ± 1.3 ） cm/s and resistance index was （0.60 ± 0. 18 ） . Most of the nodes were ovoid or fusiform with sharp border. The cortex showed low echo while the medulla showed high echo, and the board between the cortex and the medulla was sharp. There were vasculatures confined in the hilum with regularly flow or without any flow. Conclusion Ultrasound can be served as primary method in diagnosis of reactive hyperplasia of cervical lymph nodes and its follow - up in healthy people.