浅表淋巴结Kikuchi病与结核病超声对比研究  

Evaluation of ultrasound in superficial lymphnodes of Kikuchi disease and tuberculosis

作　　者：王新方[1] 叶新华[2] 黄子慧[3] 俞群[1] 韩洋[1] 李亚洲[1] 宋雨[1] 张毓[1] 

机构地区：[1]南京市中西医结合医院超声科,江苏南京210014 [2]南京医科大学第一附属医院超声医学科,江苏南京210029 [3]南京市中西医结合医院瘰疬科,江苏南京210014

出　　处：《南京医科大学学报（自然科学版）》2011年第11期1702-1706,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：南京市医学重点科技发展项目资金资助(ZKX10029)

摘　　要：目的:探讨浅表淋巴结Kikuchi病(Kikuchi disease,KD)与结核病(tuberculous lymphadenopathy,TLPN)超声表现特点,提高超声对二者的鉴别诊断能力。方法:对75例KD及215例TLPN受累浅表淋巴结二维及彩色多普勒超声表现进行回顾性分析。结果:KD和TLPN均以年轻女性多发,为颈部多区域淋巴结病变,KD多累及颈后三角区淋巴结,主要侵犯颈浅淋巴结群;TLPN主要累及颈内静脉链中组及下组淋巴结,主要侵犯颈深淋巴结群。超声表现:KD受累淋巴结多表现一致,包膜完整、锐利,淋巴门结构多较清晰,淋巴结皮质多为均质低回声,血流呈淋巴门型分布,血流密度以Ⅱ～Ⅲ级为主;TLPN受累淋巴结多无淋巴门结构,常融合成团,包膜增厚、模糊,甚至无包膜,周围组织水肿较明显;常合并有液化和(或)钙化、高回声等;血流以边缘型或无血流型多见,血流密度以0～Ⅰ级为主;频谱多普勒提示TLPN阻力指数较KD高(P<0.001)。结论:KD与TLPN病变浅表淋巴结在超声表现上具有较明显的差别,超声对其鉴别具有重要用价值,可为进一步穿刺活检提供依据。Objective： To investigate the role of ultrasound in the differential diagnosis of Kikuchi disease（KD） and tuberculous lymphadenopathy（TLPN）.Methods： An analysis included 75 cases of KD and 215 cases of TLPN with their grayscale and color doppler flow features was performed retrospectively.Results： Both KD and TLPN had yong female predominance,and mostly occurred at the neck area.On sonography KD had homogeneous appearances with intact and sharp capsules and clear hilum.The cortex in KD was homogeneous hypoechoic.The distribution of blood was hilum pattern and flow density had a predominance of grade Ⅱ～Ⅲ.In TLPN,peri-nodal edema was shown.And in most diseased nodes,the hilum disappeared,the nodes usually fused to form a mass,the capsule was thickened or even disappeared.Liquifications and calcifications were common findings in TLPN.The distribution of blood revealed peripheral type or bloodless type and flow density were mainly grade 0 ～Ⅰ.The resistive index（RI） was higher in TLPN（P 0.001）.Conclusion： The sonography apperances are distingishable between KD and TLPN of superficial lymph nodes and will supply as indications for biopsy.

关 键 词：浅表淋巴结 KIKUCHI病 结核病 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学]