颈部淋巴结核的MRI和CT影像特征与病理学对照分析  

MRI and CT features of lymph node tuberculosis of neck correlating with pathologic findings

作　　者：樊艳青[1] 谭正[1] 黄枫[1] 曹锋[2] 刘琳[3] 

机构地区：[1]武汉市医疗救治中心放射科,武汉430023 [2]武汉市医疗救治中心外科,武汉430023 [3]武汉市医疗救治中心病理科,武汉430023

出　　处：《放射学实践》2013年第6期628-631,共4页Radiologic Practice

摘　　要：目的:分析颈部淋巴结结核各病理阶段的MRI和CT表现特点,比较两种检查方法临床应用价值。方法:回顾性分析81例均经手术切除和病理学检查的颈淋巴结结核患者资料,其中45例MRI和36例CT资料。手术切除区域淋巴结影像特点与病理对照分析。比较两种影像学检查方法对病理各阶段的准确性。结果:手术区域淋巴结结核病理改变核心以第三、四阶段为主,各阶段病变并存。45例MRI检查组和36例CT检查组提示手术区域淋巴结第一至四阶段病变例数分别为25、19、42、45、16、6、18和36例;相应检查组提示病理各阶段例数25、22、45、45、16、14、34和36例。两种检查的第一、四阶段与病理结果完全一致,MRI和CT对第二、三阶段的准确度分别为87%、93%、43%和53%。结论:MRI较CT更能全面、客观反映颈淋巴结结核不同病理阶段的特征,尤其是对病理变化发展的第二、三阶段明显优于CT。Objective：To analyzed the MRI and CT features of lymph node tuberculosis in different stages, and to compare the diagnostic value of the two modalities. Methods：81 cases of lymph node tuberculosis of neck confirmed by sur-gery and pathology were analyzed retrospectively,including MRI of 45 cases and CT of 36 cases. Imaging features were cor related with pathological results. The accuracy of two modalities for different pathological stages were compared. Results： Pathologically,the lymph node tuberculosis of neck was divided in four stages. There was co-existance of different stages in same patient,while lessions of stage 11I and IV were mostly observed in the operation region. There were 25,19,42 and 45 lesions of grade Ⅰ, Ⅱ, Ⅲ and Ⅳ respectively observed on MRI and 16,6,18 and 36 lesions of grade Ⅰ,Ⅱ ,Ⅲ, IV ,respec tively observed on CT. The MRI and CT features were consistant with pathological results in stage Ⅰ and IV. In stage Ⅱ and Ⅲ , the accuracy of MRI was 87% and 93%,while that of CT was 43% and 53%. Conclusion： MRI can more compre- hensively and objectively reflect the characteristics of different pathological stages of lymph node tuberculosis of neck than CT. Especially in stage Ⅱ and Ⅲ of the disease MRI is significantly superior to CT.

关 键 词：结核 淋巴结 病理学 磁共振成像 体层摄影术 X线计算机 

分 类 号：R445.2[医药卫生—影像医学与核医学] R814.42[医药卫生—诊断学]