28例颈部淋巴结结核的MRI表现分析

MRI features of cervical lymph node tuberculosis： a study of 28 cases

目的分析颈部淋巴结结核MRI影像学特点，提高对该病的认识和诊疗水平。方法回顾性分析2013年1月至2016年1月在广州市增城区人民医院及中山大学孙逸仙纪念医院行MRI检查，并经淋巴结活检或切除术后病理证实的28例颈部淋巴结结核患者的临床及影像资料。其中，男16例，女12例；患者年龄在18～72岁，中位年龄36岁。结果28例颈部淋巴结结核患者中，单侧发病4例，双侧发病24例。干酪样坏死部分T2WI及T2短时反转恢复序列（short time inversion recovery，STIR）成像均呈不均匀等或稍高混杂信号；弥散加权成像（diffusion weighted imaging，DWI）实性部分呈高信号，坏死区呈等或稍高信号；增强扫描实性部分呈环形强化，坏死部分无强化，表观扩散系数（apparent diffusion coeffecient，ADC）值为（1．27±0．15）×10^-3mm^2／s，实性部分ADC值为（1．06±0．11）×10^-3mm^2／s。结论MRI能准确反映颈部淋巴结结核不同病理阶段的特征，ADC值诊断颈部淋巴结结核具有较高的临床价值。

Objective To analysis the MRI features of cervical lymph node tuberculosis,and to investigate the role of MRI in lymph node tuberculosis. Methods Twenty-eight patients diagnosed cervical lymph node tubercu- losis by operation or needle biopsy were admitted to The People＇s Hospital of Zengcheng of Guangzhou or Sun Yat- sen Memorial Hospital of Sun Yat-sen University from January 2013 to January 2016 （male： 16, female： 12;age： 18- 72 years old, median age 36 years old）. To analyze the clinical and imaging data of tuberculosis of cervical lymph nodes. Results Of all the 28 patients, 4 cases were involved with lesions located at one side of the neck,and the other 24 cases were on bilateral cervical. On the T2WI and T2 short time inversion recovery （STIR）, the necrotic parts were showed mixed or slightly hyperintense. On DWI, the necrotic parts were iso or slightly hyperintense and the apparent diffusion coeffecient （ADC） values were （1.27±0.15）× 10^-3 mm^2/s, the solid portion were hyperin- tense and the ADC values were （1.06±0. 11））× 10^-3 mm^2/s. After enhancement, the solid parts were ring- enhanced and the necrotic portions had no enhancement. Conclusion MRI can reflect the characteristics of cervical lymph node tuberculosis in different pathological stages accurately, and the ADC values can be helpful for diagnosing cervical lymph node tuberculosis.