彩色多普勒超声对颈部淋巴结结核的诊断及鉴别诊断  

Color Doppler Ultrasound in Diagnosis and Differential Diagnosis of Cervical Tuberculous Lymphadenitis

作　　者：文萍[1] 肖秋金[1] 刘蓓[1] 邓晓莉[1] 

机构地区：[1]中国人民解放军第九四医院特诊科,南昌330002

出　　处：《南昌大学学报（医学版）》2011年第9期70-72,共3页Journal of Nanchang University：Medical Sciences

摘　　要：目的应用彩色多普勒探讨颈部淋巴结结核的超声特点和鉴别诊断。方法对85例颈部肿大的淋巴结的超声特点进行回顾性分析,其中35例临床确诊为颈部淋巴结结核,25例为转移性淋巴结,25例为反应性淋巴结。结果 35例颈部淋巴结结核中,超声检查肿大的淋巴结多位于胸锁乳突肌周围,淋巴结之间有粘连、融合现象,根据声像图的不同表现分为干酪脓肿型、增殖结节型、混合型。形态呈椭圆形,L/S比值与反应性淋巴结无显著差异(P>0.05),与恶性淋巴结相比有显著差异(P<0.01)。35例淋巴结核中,20例出现淋巴门血流,淋巴结内血管数目较少,血流动力学显示频谱形态为低阻力型,阻力指数与反应性淋巴结无显著差异,与恶性淋巴结相比有显著差异。结论颈部淋巴结结核临床表现虽然不典型,但超声检查有一定的特点,通过这些特点的分析,结合其他辅助检查,有助于该病与慢性淋巴结炎、颈部转移癌、淋巴瘤等疾病的鉴别。Objective To investigate the ultrasound characteristics of cervical tuberculous lymphadenitis（CTL） using color Doppler sonography for differential diagnosis.Methods The ultrasound characteristics of 85 cases of enlarged cervical lymph nodes（35 cases of clinically diagnosed cervical tuberculous lymphadenitis,25 cases of metastatic lymphadenopathy and 25 cases of reactive lymphadenopathy） were retrospectively analyzed.Results In the 35 patients with cervical tuberculous lymphadenitis,enlarged lymph nodes detected by ultrasound were mainly located around the sternocleidomastoid muscles.The adhesion and fusion were present between the lymph nodes.According to varied sonographic manifestations,lymph nodes were classified into cheese abscess type,nodular proliferation type and mixed type.The lymph nodes showed oval shape with fewer blood vessels.Twenty cases of cervical tuberculous lymphadenitis showed the presence of hilar blood flow.Hemodynamic findings suggested that the spectral shape belonged to low resistance type.The L/S ratio and resistive index in cervical tuberculous lymphadenitis were not significantly different from reactive lymphadenopathy（P0.05）,but were obviously different from malignant lymphadenopathy（P0.01）.Conclusion Although the clinical manifestations of cervical tuberculous lymphadenitis are not typical,certain characteristics may be identified through ultrasound analysis.These characteristics,together with other auxiliary examinations,can be used in the differential diagnosis of chronic lymphadenitis,cervical metastatic carcinoma,lymphoma and others.

关 键 词：淋巴结结核 颈部 彩色多普勒超声 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]