肺内淋巴结的超声CT特点及与病理对照分析

Ultrasonic CT Characteristics of Intrapulmonary Lymph Nodes and Their Comparative Analysis with Pathology

目的:研究肺内淋巴结的超声CT(超声层析成像技术)特点及其与病理的对照,加深对肺内淋巴结的认识。方法:在2015年10月~2018年10月于本院心肺科接受手术治疗的患者中,随机选取40例,40例患者均经手术及病理证实为肺内淋巴结,共50枚肺内淋巴结,其中男性22例,女性18例。手术前对患者超声CT扫描,并进行1mm薄层重建,对CT征象利用双盲法进行分析,并与组织病理进行对照。结果:40例患者肺内淋巴结均在气管隆突水平下,33枚位于右肺,17枚位于左肺;34枚为类圆形,16枚为棱形或三角形;最小径0.26cm,最大径1.27cm,平均(0.65±0.22)cm,其中46枚<1.0cm;29例患者为肺内单发淋巴结,11例为肺内多发淋巴结;50枚淋巴结均为实性结节,CT值范围20~105HU,中位值为42HU,未见空泡、钙化、空气支气管征;50枚淋巴结边界均表现光滑、清晰,46枚距胸膜≤1.0cm,15枚与胸膜紧贴,6枚紧贴叶间裂;50枚淋巴结均为黑色、暗褐色结节,质韧偏硬,边界有包膜,有程度不同的炭末沉积;50枚淋巴结均未见血管集束征、胸膜凹陷征、卫星灶,23枚周边见细线影。结论:肺内淋巴结为良性的肺内结节,超声CT有一定特点,病理改变较为典型,可利用术前超声CT表现对其进行判断。

Objective:To study the characteristics of intrapulmonary lymph nodes(CT)and their comparison with pathology,so as to deepen the understanding of intrapulmonary lymph nodes.Methods:40 patients were randomly selected.All 40 patients were confirmed to be intrapulmonary lymph nodes by operation and pathology.There were 50 intrapulmonary lymph nodes,including 22 males and 18 females.Before operation,ultrasound CT scan and 1mm thin layer reconstruction were performed,and the signs of CT were analyzed by double blind method.Results:All the pulmonary lymph nodes of 40 patients were located in the right lung and 17 in the left lung,34 were round,16 were prism or triangle,the minimum diameter was 0.26 cm,the maximum diameter was 1.27 cm,the average was(0.65±0.22)cm,46 patients with<1.0cm≤29 patients had single intrapulmonary lymph nodes,11 patients had multiple intrapulmonary lymph nodes,and the minimum diameter was 0.26 cm and the maximum diameter was 1.27 cm,with an average of(0.65±0.22)cm.All the 50 lymph nodes were solid nodules,the CT value was 20 HU≥105 HU,the median value was 42 HU,no vacuole,calcification and air bronchus sign were found,and the boundary of 50 lymph nodes was smooth.Clear,46 from pleura≤1.0cm.Conclusion:The intrapulmonary lymph nodes are benign intrapulmonary nodules.Ultrasonic CT has certain characteristics and typical pathological changes.It can be judged by preoperative ultrasound CT findings.