伴有淋巴结坏死的淋巴瘤与淋巴结结核的增强CT征象对比分析

Comparison on enhanced CT manifestations between lymphoma accompanied with necrotic lymph node and lymph node tuberculosis

目的:对比分析伴有淋巴结坏死的淋巴瘤与淋巴结结核的增强CT表现,以提高对两者的鉴别诊断水平。方法:回顾性分析经病理证实的21例伴有淋巴结坏死的淋巴瘤及35例淋巴结结核的增强CT表现,分析两者融合情况、坏死淋巴结大小、坏死淋巴结占受累淋巴结比例、坏死淋巴结强化形态、坏死范围及坏死区CT值的差异。结果:CT征象比较:1融合情况:淋巴瘤组和结核组2组间差异无统计学意义(χ2=0.479,P=0.489)。2坏死淋巴结大小:淋巴瘤组坏死淋巴结短径(3.09±1.44)cm明显大于结核组坏死淋巴结短径(1.45±0.67)cm,2组差异有统计学意义(t=5.74,P=0.000)。3坏死淋巴结占受累淋巴结比例:结核组较淋巴瘤组更容易出现坏死淋巴结为主型,而少淋巴结坏死型则在淋巴瘤组出现的几率显著增高(χ2=15.157,P=0.000)。4坏死淋巴结强化形态:淋巴瘤组较结核组出现不规则强化的几率更高(χ2=8.443,P=0.004)。5淋巴结坏死范围及坏死区域CT值:淋巴瘤组与结核组坏死淋巴结的坏死范围有所差异,坏死范围<50%的淋巴结在淋巴瘤组更为常见(χ2=30.366,P=0.000)。淋巴瘤组淋巴结坏死区域CT值(39.2±9.5)HU与结核组淋巴结坏死区域CT值(40.4±10.9)HU差异无统计学意义(t=-0.412,P=0.682)。结论:伴有淋巴结坏死的淋巴瘤与淋巴结结核的CT增强表现存在一定差异,淋巴瘤时坏死淋巴结占受累淋巴结的比例较小,坏死淋巴结相对较大,以不规则强化为主,坏死范围多较小。

Objective：To compare the CT manifestation between lymphoma accompanied with necrotic lymph node and lymph node tuberculosis. Methods：CT findings were reviewed in 21 patients with lymphoma accompanied with necrotic lymph node and in 35 patients with lymph node tuberculosis. The differences in the discreteness,size,proportion,enhanced form,necrotic area and CT value between necrotic lymph node in lymphoma and lymph node tuberculosis were analyzed. Results：CT findings：1Discreteness：no sta tistical significant discrepancy was found between the two groups（χ^2= 0. 479,P = 0. 489）. 2 Size ：the short dimension of necrotic lymph node in lymphoma group（3.09±1.44）cm was significantly longer than that in lymph node tuberculosis group（1.45±0.67）cm（t=5.74,P=0.000）. 3Proportion：the necrotic lymph node predominance type was more commonly seen in the lymph node tuberculosis group,but the necrotic lymph node minority type was more commonly seen in the lymphoma group（χ^2=15.157,P=0.000）. 4Enhanced form：non-regular enhancement was more commonly seen in the lymphoma group（χ^2=8.443,P=0.004.）5Necrotic area and CT value：the necrotic area less than 50% was more commonly seen in the lymphoma group（χ^2=30.366,P=0.000）. The CT value of necrotic area was（39.2±9.5）HU in the lymphoma group and（40.4±10.9）HU in the lymph node tuberculosis group. No statistical significant CT value was found between the two groups（t=-0.412,P=0.682）. Conclusion：There are differences in the CT manifestation between lymphoma accompanied with necrotic lymph node and lymph node tuberculosis. The necrotic lymph node minority type is more commonly seen in the lymphoma group;the necrotic lymph node is bigger in size and non-regularly enhanced,and the necrotic area is small.