颈部淋巴结结核CT及MRI诊断

CT and MRI in diagnosis of cervical lymph node tuberculosis

目的探讨颈部淋巴结结核的CT及MRI表现，提高对颈部淋巴结结核CT及MRI诊断的认识。方法回顾性分析47例颈部淋巴结结核的CT及MRI影像表现特征，全部病例均经手术或活检病理证实。其中男性18例，女性29例。年龄11-72岁，47例患者28例行CT平扫及增强扫描，10例行MRI扫描，9例同时行CT及MR检查。结果根据病理颈部淋巴结结核的CT及MRI表现可分为4型。Ⅰ型：结核结节及肉芽肿形成3例；Ⅱ型：淋巴结干酪样坏死7例；Ⅲ型：淋巴结包膜坏死9例；IV型：淋巴结干酪样坏死破溃并向周围侵犯28例。结论CT尤其是MRI在颈部淋巴结结核的诊断及疗效观察方面有着重要的价值，可以明确病变的部位、数目、大小、形态特征及与周围组织的关系，同时可以反映其病理改变。

Objective To investigate the CT and MRI findings of the cervical lymph node tuberculosis, and improve the diagnosis of cervical lymph node tuberculosis. Methods CT and MRI findings of the cervical lymph node tuberculosis confirmed by operation or biopsy in 47 cases were analyzed retrospectively. 18 cases were male ,29 cases were female, with age from 11 to 72.28 patients underwent CT native and enhanced scan,19 patients underwent MR1 scan, among which 9 patients underwent both CT and MRI. Results The corresponded pathologic finding of the cervical lymph node tuberculo- sis can be classified into four types, type I -3 cases of tubercle nodules and granuloma,type U ：7 cases of lymphoglandu- la caseousnecrosis, type m .9 cases of destruction of lymph node capsule, type IV ：28 cases of lymphoglandula caseousne- crosis,capsule ruptured and invaded the surrounding tissue. Conclusion CT especially MRI can well demonstra the number,location,site and the surroundings of tuberculosis, and reflect the pathological features; they are the important methods for the diagnosis and curative efficacy assessment for cervical lymph node tuberculosis.