腹内淋巴结结核的影像学诊断  

Imaging diagnosis for abdominal tuberculous lymphadenopathy

作　　者：余日胜[1] 李蓉芬[1] 魏芳[2] 殷君大[2] 

机构地区：[1]浙江大学医学院附属第二医院放射科,杭州310009 [2]浙江大学医学院附属第二医院B超室,杭州310009

出　　处：《中华结核和呼吸杂志》2000年第12期715-717,I029,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的探讨腹内淋巴结结核的影像学诊断价值。方法对经临床病理证实的腹内淋巴结结核２７例进行分析，所有病例均经多种影像学检查。结果典型的ＣＴ表现是环形强化的肿大淋巴结，淋巴结内钙化少见但有重要诊断价值。Ｂ超显示大于２．０ｃｍ的肿大淋巴结肉呈不均回声，部分伴有无回声；小于 ２．０ ｃｍ者内部回声均匀。胃肠钡餐造影意义在于检出淋巴结结核合并胃肠道结核或直接侵犯小肠。腹部Ｘ线平片可发现淋巴结钙化和肠梗阻。结论各种影像学检查对腹内淋巴结结核均有一定诊断价值，以ＣＴ诊断价值最高，Ｂ超更适合于复查病例。Objective To evaluate the value of X-ray imaging for diagnosing abdominal tuberculous lymphadenopathy.Methods 27 cases of tuberculous lymphadenopathy proved by clinicl or pathohistological evidence were collected, all of which were examined with radiological imaging methods.Results The typical CT findings enlarged lymph nodes with peripheral or multilocular enhancement. Enlarged lymph nodes with multiple flecked or massive calcifications were important for diagnosis. Ultrasound examination showed enlarged lymph nodes with uniform echo (less than 2 cm) and with heterogeneous echa (lrger than 2 cm). The aim of the barium meal examination of the gastrointestinal tract was to find tuberculous lymphadenopathy encroaching on intestine or merged with intestinal tuberculosis. Abdominal X-ray plain film was helpful to find the calcified tuberculous lymphadenopathy and intestinal obstruction.Conchusions Various imaging methods have shown their diagnostic value, but CT was the most important tool for definite diagnosis of tuberculous lymphadenopathy. Ultrasound was more useful for follow-up cases.

关 键 词：结核 淋巴结 诊断显像 

分 类 号：R522[医药卫生—内科学]