摘要:
目的：分析淋巴结结核的CT和MRI表现特点，并与病理学对照，探讨两种检查方法的应用价值。方法：回顾性分析2010年1月至2014年12月间34例经手术、穿刺病理或临床证实为淋巴结结核患者的CT或MRI影像学资料，分别从生长方式（融合/非融合）、边缘（光滑/欠光滑）、境界（清晰/欠清晰）、密度及信号、增强后强化方式（均匀/不均匀/环形规则/环形不规则）这5个方面对所受累淋巴结进行分析。结果：34例患者中共累及223枚淋巴结，其中颈部淋巴结67.7%，纵隔内淋巴结27.7%，肺门淋巴1.8%，肺内淋巴结0.5%，腹腔淋巴结0.5%，腹膜后淋巴结1.8%。所有受累淋巴结中，8.5%呈融合性生长，83.9%形态规则，79.4%边缘光滑。CT上发现的171枚病变淋巴结以等密度较多（53.8%）、低密度次之（43.3%），MRI上发现的66枚病变淋巴结中98.5%为等T1长T2信号。所有CT及MRI观察到的病变淋巴结中，除57%的病灶密度或信号均匀外，仅伴钙化的为12.6%，仅伴部分坏死的26.9%，另外有3.6%同时伴钙化及坏死；增强扫描的204个病变淋巴结中，1%钙化显著、未见明显强化，38.7%均匀强化，伴坏死者内见不强化的低密度区，11.3%呈环形规则强化（均位于颈部），8.3%环形不规则强化（纵隔内82.4%），5.9%可见病变淋巴结内有分隔样强化（均位于颈部）。结论：CT与MRI对于淋巴结结核具有重要诊断价值，两者均能清晰显示病变部位、形态以及边缘情况，MRI对于病变边缘及周围情况显示较CT更明确，尤其是增强后，对于包膜及邻近组织受累情况的显示也更加敏感。
Abstract:
Objective:To explore the application value of the two methods by analyzing the CT and MRI features of lymph node tuberculosis and comparing with pathology. Methods:From January 2010 to December 2014, CT or MRI imaging data of 34 patients with lymph node tuberculosis confirmed by operation, puncture pathology or clinical were analyzed retrospectively, including growth pattern(fusion/non-fusion), edge(smooth not smooth), realm(clear/unclear), density and signal, enhancing mode(uniform/non-uniform/circular regular/annular irregular). Results:A total of 223 lymph nodes were involved in 34 patients, including 67.7% of cervical lymph nodes, 27.7% of mediastinal lymph nodes, 1.8% of hilar lymph nodes, 0.5% of intraperitoneal lymph nodes, and 1.8% of retroperitoneal lymph nodes. Of all the involved lymph nodes, 8.5% showed fusion growth, 83.9% had regular morphology, 79.4% had smooth margin. 171 lesions were found on CT, with more equal density(53.8%), followed by low density(43.3%), and 98.5% of 66 lesions on MRI showed equal T1 long T2 signal. In all the lymph nodes observed by CT and MRI, in addition to 57% of the lesions with uniform density or signal, only12.6% accompanied by calcification, only 26.9% accompanied by partial necrosis, and 3.6% accompanied by calcification and necrosis at the same time; in 204 lymph nodes under enhanced scanning, 1% of the calcification was significant, no obvious enhancement was found, 38.7% of the lymph nodes were uniformly enhanced, and the low-density areas without enhancement were found in the patients with damage, 11.3% showed ring-shaped pattern 8.3% of the cases with ring irregular enhancement were in mediastinum(82.4%), and 5.9% of the cases showed septal enhancement in lymph nodes. Conclusion:CT and MRI have important diagnostic value for lymph node tuberculosis. Both of them can clearly show the location, shape and edge of the disease. MRI was more specific than CT in showing the edge and periphery of the lesion, especially after enhancement, and it was more sensitive to the involvement of capsule and adjacent tissues.
百度学术
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