MSCT对纵隔淋巴结结核和纵隔淋巴结转移瘤诊断价值  

MSCT diagnosis of mediastinal lymph node tuberculosis and mediastinal lymph node metastasis

作　　者：林娜[1,2] 徐卓东[3] 袁小记 焦慧[3] LIN Na;XU Zhuodong;YUAN Xiaoji;JIAO Hui(CT Room of Shandong Medical Imaging Research Institute Affiliated to Shandong University,Jinan 250011,P.R.China;Radiologist Department of Shandong Provincial Chest Hospital,Jinan 250013,P.R.China)

机构地区：[1]山东大学附属山东省医学影像学研究所CT室,山东济南250021 [2]山东大学附属山东省胸科医院影像科,山东济南250013 [3]山东大学附属山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2021年第1期33-36,共4页Journal of Medical Imaging

摘　　要：目的探讨多层螺旋CT(MSCT)对纵隔淋巴结结核和纵隔淋巴结转移瘤的诊断价值。方法选取50例纵隔淋巴结结核及26例纵隔淋巴结转移瘤的MSCT影像资料,记录病变分布、大小、密度、融合、强化方式、邻近组织受累情况,进行对比分析。结果成人纵隔淋巴结结核比转移瘤更易累及4R、2R、7区淋巴结。前者病灶直径在1~4 cm之间、密度不均匀占比高于后者,差异有统计学意义。增强方式前者以环形、分隔样强化为主,后者以均匀强化、厚薄不一环形强化为主,差异有统计学意义。纵隔淋巴结结核可致支气管淋巴结瘘形成,瘘口处病灶无强化,纵隔淋巴结转移瘤可包绕邻近血管,邻近组织受累时见强化,两者差异有统计学意义。结论纵隔淋巴结结核与转移瘤有不同的优势解剖分布和影像学特征,MSCT平扫及动态增强有助于二者鉴别。Objective To investigate the value of MSCT in differential diagnosis of mediastinal tuberculosis and metastasis of lymph node in adults.Methods The imaging data of 50 cases of tuberculosis and 26 cases of metastasis of mediastinal lymph nodes was retrospectively reviewed.The size,density,fusion,enhanced pattern of the lesion and the situation of invasion or embedment of mediastinal great vessels were analyzed.Results Compared to metastasis,the lymph nodal regions of 4R,2R and 7 had a higher tendency to be involved in tuberculosis.Tuberculosis had a higher tendency of 1-4cm in diameter,as well as calcification foci and inhomogeneous density.The difference was statistically significant.There was also a significant difference in enhancement pattern between the two kinds of disease.Characteristics of tuberculosis on enhanced MSCT manifested as annular reinforcement and annular fine separation enhancement,and usually characterized by many different forms of enhancement pattern.And characteristics of metastasis were mainly formed by homogeneous enhancement with uneven thickness ring enhancement.During the ruptures stage of mediastinal lymphatic tuberculosis,bronchial lymph node fistula can be observed,with no enhancement of the fistula site.Mediastinal lymph node of metastasis can surround adjacent vessels,and the enhancement can be observed when the adjacent trachea and bronchial tissues were involved.Conclusion For tuberculosis and metastasis,dominant anatomic distribution of the mediastinal lymph nodes exists.MSCT morphology characteristics and enhanced patterns are useful in the differential diagnosis of these two diseases.

关 键 词：纵隔淋巴结 结核 转移瘤 体层摄影术 X线计算机 

分 类 号：R734.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]