颈部淋巴结结核与转移性病变的超声鉴别诊断价值  

Differential Diagnostic Value of Two-dimensional Ultrasonography in Tuberculous Cervical Lymphadenitis and Metastatic Cervical Lymph Nodes

作　　者：吕晓玉[1,2] 郝轶[2] 姚兰辉[1] 

机构地区：[1]新疆医科大学第一附属医院超声科,新疆乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院超声科

出　　处：《华南国防医学杂志》2013年第9期618-621,633,共5页Military Medical Journal of South China

基　　金：国家自然科学基金项目(81260219)

摘　　要：目的探讨超声在鉴别诊断颈部结核性淋巴结与转移性淋巴结中的价值。方法回顾性分析105例患者的160个淋巴结,其中结核性淋巴结76个,转移性淋巴结84个。对照分析两组淋巴结下列超声表现:L/S、边界、淋巴门、内部回声、钙化、液化,评价其诊断价值。结果两组内部均可呈现钙化和液性无回声区。而转移性淋巴结内部钙化多为微钙化,呈簇状分布,结核性淋巴结内多为散在粗钙化,两者间差异有统计学意义(P<0.01)。转移性淋巴结内部液化区多偏心分布且面积比<50%,结核性淋巴结内液化区多位于中央且面积比>50%,两者间差异有统计学意义(P<0.01)。结论钙化的大小与分布、液化区的位置与面积比有助于鉴别颈部结核性淋巴结与转移性淋巴结。Objective To investigate the value of two-dimensional ultrasonography in differential diagnoisis between tuberculous cervical lymphadenitis and metastatic cervical lymph nodes. Methods A total of 160 lymph nodes in 105 patients including 76 tuberculous lymph nodes and 84 metastatic lymph nodes were retrospectively analysed. The sonograph ic manifestations including L/S, borders, lymphatic doors, internal echo, calcification and liquefaction were analysed and compared between two groups, and the diagnostic values were evaluated. Results Calcification and echo-free zone were observed in both groups. Inside the metastatic lymph node microcalcification with a cluster distribution was observed, and inside the tuberculous lymph nodes scattered coarse calcification was observed （P〈0. 01）. The liquefied area inside metastatic lymph node had eccentric distribution and 〈50 % area ratio, the liquefied area inside tuberculous lymph nodes mostly located in the center and the area ratio was 〉50% （P〈0. 01）. Conclusion The distribution and the size of calcification, the position and area ratio of liquefied area is helpful in the differential diagnosis of cervical tuberculous lymphadenitis and metastatic lymph nodes.

关 键 词：二维超声 结核性 转移性 淋巴结 

分 类 号：R551.2[医药卫生—血液循环系统疾病]