腹部淋巴结结核的CT和MRI诊断  

CT and MRI diagnosis of abdominal lymph nodes tuberculosis

作　　者：周智红 王敏杰 王纪龙 庄奇新[2] 

机构地区：[1]上海市金山区中心医院放射科,上海201500 [2]上海市第六人民医院放射科,上海200233

出　　处：《上海医学影像》2012年第1期55-57,共3页Shanghai Medical Imaging

摘　　要：目的分析腹部淋巴结结核的CT和MRI表现,提高对腹部淋巴结结核的影像学鉴别诊断水平。方法搜集8例经手术、病理或临床追踪随访证实的腹部淋巴结结核病例临床资料,8例均行CT平扫加增强检查,其中3例另做MRI检查,观察患者病变的常见解剖部位、影像学形态及影像增强后强化方式的特点。结果 8例腹部淋巴结结核病例中,3例位于肠系膜根部,3例位于腹主动脉与下腔静脉间,2例在胰头周围和小网膜囊。8例中,2例淋巴结呈1 cm大小、多发结节状,CT注入造影剂有轻度均匀强化;6例淋巴结融合成不规则肿块状,CT增强后呈"多房样"环形强化。MRI T1加权像呈低信号、T2加权像高信号,中央为更高信号,增强后见环形强化。结论腹部淋巴结结核的CT、MRI表现具有一定的特征性,需要与其他淋巴结病变相鉴别。Objective To study the CT and MRI features of abdominal lymphatic tuberculosis so as to improve the imaging differential diagnosis.Methods The clinical data of 8 cases with abdominal lymphatic tuberculosis confirmed by surgery,pathology or clinical follow-up were collected including plain and enhanced CT in all 8 cases,and MRI in 3 cases.The anatomical distribution,morphologic features and mode of contrast enhancement were closely analyzed.Results The destination of lesion in all 8 cases included mesenteric root for 3cases,inter between abdominal vena and in lesions bursa cava 3,around the pancetta head and predation bursa 2.Lymph node size was 1 cm with multiple nodule appearance and mild homogeneous CT enhancement in 2 cases and blending into irregular mass with ＂multi-local＂ lung.CT enhancement and T1WI low intense signal,T2WI high intense signal,especially in central area,associated with lung enhancement on MRI.Conclusion CT and MRI appearance of abdominal lymphatic tuberculosis is characteristic,and need to be differentiated from other lymphadenopathy.

关 键 词：结核 淋巴结 腹部 CT MRI 

分 类 号：R445.2[医药卫生—影像医学与核医学] R445.3[医药卫生—诊断学]