直径大于2.0厘米的成人纵隔淋巴结结核CT增强表现  

Mediastinal tuberculous lymphadenitis in adults with diameters more than 2.0 cm:contrast-enhanced CT features

作　　者：戴金武[1] 周新华[2] 

机构地区：[1]广东省佛山市顺德区慢性病防治中心,佛山528300 [2]北京结核病胸部肿瘤研究所,北京101149

出　　处：《中国防痨杂志》2007年第1期31-33,共3页Chinese Journal of Antituberculosis

摘　　要：目的评价直径≥2．0 cm的成人纵隔淋巴结结核CT增强表现。方法对21例经过手术、纵隔镜、穿刺活检证实的直径≥2．0 cm的纵隔淋巴结结核患者共76个淋巴结进行影像学分析,其中男13例,女8例,年龄16～60岁,中位年龄28岁。所有病例均做CT增强扫描。结果根据病灶强化形态学特征分为5种强化类型:(1)不均匀强化27个(35．5％);(2)环形强化共有23(30．3％);(3)均匀强化15个(19．7％);(4)无明显强化6个(7．9％);(5)分隔样强化5个(6．6％)。21例纵隔淋巴结结核中12例(57．1％)淋巴结强化以2种或2种以上类型联合存在。其余9例(42．9％)是以单一强化类型表现。结论直径≥2．0 cm的淋巴结结核依次以不均匀强化、环形强化、均匀强化和无强化为主要表现。当淋巴结环形强化、分隔样强化时应首先考虑为淋巴结结核。Objective To evaluate the contrast-enhanced CT features of mediastinal tuberculous lymphadenitis in adults with diameters more than 2.0 cm. Methods Twenty-one patients with 76 lymph nodes diagnosed as mediastinal tuberculous lymphadenitis by operation, mediastinoscopy and biopsy were evaluated on enhanced CT scan, including 13 male and 8 female. The median age of the patients was 28 years old （range from 16 - 60 years old）. Results Five post-contrast patterns of enhancement were found： （ 1 ） inhomogeneous enhancement （35.3 % ） ; （2） peripheral rim enhancement （ 30.0 % ） ; （ 3 ） homogeneous enhancement （ 19.7 % ） ; （4） nonenhancement（7.9% ） ; （5） separate enhancement （6.6%）. 12 patients （57.1% ） had a combination of enhancement patterns. 9 patients（42.9 % ）had a single enhancement pattern. Conclusion Contrast-enhanced CT appearance of mediastinal tuberculous lymphadenitis with diameter ≥ 2.0 cm was mainly inhomogeneous enhancement and peripheral rim enhancement. But peripheral rim enhancement or separate enhancement can suggest a diagnosis of tuberculosis.

关 键 词：纵隔 结核 淋巴结 体层摄影术 X线计算机 

分 类 号：R522[医药卫生—内科学]