肺内淋巴结的多层螺旋CT特征分析  

Multi⁃slice spiral CT features of intrapulmonary lymph nodes

作　　者：谭瑜 邓皓林 郑晓涛[1] 万齐[1] 雷永霞[1] 孙翀鹏[1] 李新春[1] 邓宇[1] Tan Yu;Deng Haolin;Zheng Xiaotao;Wan Qi;Lei Yongxia;Sun Chongpeng;Li Xinchun;Deng Yu(Department of Radiology,First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120;Department of Radiology,Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]广州医科大学附属第一医院放射科,广东广州510120 [2]广州市胸科医院放射科,广东广州510095

出　　处：《广州医科大学学报》2021年第2期32-36,64,共6页Academic Journal of Guangzhou Medical University

摘　　要：目的:分析肺内淋巴结(IPLN)的多层螺旋CT特征表现,提高对该病变的认识及诊断水平。方法:回顾性分析2011年9月至2018年12月广州医科大学附属第一医院收治80例患者共96个IPLN的多层螺旋CT表现,记录IPLN的位置、大小、形态、边界、数量、密度、与邻近胸膜的关系及随访变化。结果:80例患者中67例(83.8%)IPLN为单发,13例(16.2%)为多发。位于肺上叶者17个、肺中叶21个、肺下叶58个。IPLN长径2.0~11.4 mm,平均(6.0±1.9)mm。55个IPLN紧贴胸膜,41个IPLN距离胸膜平均(4.73±2.50)mm。IPLN多呈类圆形(52.1%,50/96)及卵圆形(19.8%,19/96),也可为三角形(16.7%,16/96)或多边形(11.5%,11/96)。大部分IPLN(91.7%,88/96)边界清晰,39个见线状影相连。平扫CT值中位数为48.5 HU(10~96 HU),增强前后差值中位数为14 HU(0~49 HU)。随访期间IPLN均未见明确变化。结论:CT发现两肺中下叶紧贴胸膜或胸膜下的实性小结节,特别是长径10 mm以内,密度较高并轻度强化,且有线状影与胸膜相连时,需考虑IPLN的可能。Objective:To summarize the features of multi⁃slice spiral CT of intrapulmonary lymph nodes(IPLN),and to improve the understanding and diagnosis of the condition.Methods:Included in this retrospective study were multi⁃slice spiral CT findings of 96 IPLNs in 80 patients admitted to First Affiliated Hospital of Guangzhou Medical University between September 2011 and December 2018.The IPLNs were recorded for their location,size,shape,boundary,number,density,relationship with adjacent pleura,and changes in follow⁃up.Results:Of the 80 patients,67(83.8%)had single IPLN and 13(16.2%)had multiple IPLN.There were 17 in the upper lobes,21 in the middle lobes,and 58 in the lower lobes,of the lung.The IPLNs measured 2.0 to 11.4 mm by long diameter,with a mean of(6.0±1.9)mm.Fifty⁃five IPLNs were closely adjacent to the pleura,while 41 others were(4.73±2.50)mm apart from the pleura.The IPLN were commonly round(52.1%,50/96)and oval(19.8%,19/96)in shape,although some appeared triangular(16.7%,16/96)or polygonal(11.5%,11/96).Most of the IPLNs(91.7%,88/96)were well⁃demarcated,and 39 were connected by linear shadows.The median CT value was 48.5 HU(10~96 HU)on plain scans,with a median difference before and after enhancement being 14 HU(0~49 HU).There was no signifcant changes in IPLN during the follow⁃up.Conclusion:On CT,IPLN should be considered for solid nodules in the middle or lower lobes of the lungs,closely adjacent to or beneath the pleura,in particular,those measuring<10 mm by long diameter,with higher density and mild enhancement,and presenting linear shadow connecting to the pleura.

关 键 词：肺内淋巴结 肺结节 多层螺旋CT 

分 类 号：R816.4[医药卫生—放射医学]