高频超声对婴幼儿卡介苗性淋巴结核的诊断价值  

The application value of high frequency ultrasound in diagnosis of BCG lymphoid tuberculosis in infants

作　　者：刘蕾[1] 李红艳[1] 樊艳辉[1] 贺新建[1] LIU Lei;LI Hongyan;FAN Yanhui(Deparment of UItrasonic Diagnosis,Hebei Provincial Children’s Hospital,Hebei,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院超声诊断科,石家庄市050031

出　　处：《河北医药》2022年第5期754-757,共4页Hebei Medical Journal

摘　　要：目的探讨婴幼儿卡介苗性淋巴结核的高频超声图像表现,并结合病理实证结果,对其声像图进行分析,探讨超声图像分型特征,提高临床诊断的准确率。方法回顾性分析2013年2月至2017年5月经手术病理或穿刺活检证实的30例卡介苗性淋巴结核患儿,根据声像图特征及病理结果,提出不同的分型特征与超声诊断方法。结果因婴幼儿卡介苗性淋巴结核病程发展及就诊时间不同,其声像图表现复杂多样。根据声像图表现分为4型:Ⅰ型7例:回声均匀型,病理表现为炎性渗出为主,内部结构无明显破坏;Ⅱ型12例:回声不均匀型,病理表现为典型结核肉芽肿结构,肉芽肿中心可见微小干酪样坏死区;Ⅲ型9例:囊实性团块型,病理表现为周边为不均匀增厚的不典型肉芽肿,中央为干酪样坏死区;Ⅳ型2例:愈合钙化型,内可见粗大钙化斑,病理表现为纤维组织增生、坏死。结论婴幼儿在接种卡介苗部位同侧腋窝或锁骨上出现包块,可利用高频超声对婴幼儿卡介苗性淋巴结核进行诊断,可作为该疾病首选检查方法。Objective To investigate the high frequency ultrasound imaging findings of BCG vaccination lymphoid tuberculosis in infants,so as to improve the accuracy rate of clinical diagnosis.Methods The clinical data about 30 infants with BCG vaccination lymphoid tuberculosis who were confirmed pathologically by operation or aspiration biopsy from February 2013 to May 2017 were retrospectively analyzed.According to sonographic features and pathological results,the different classification features and ultrasonic diagnostic methods were put forward.Results Due to the different progress of the course of disease and visiting time,the sonographic manifestations of BCG vaccination lymphoid tuberculosis in infants were complex and diverse.According to the sonographic features and pathological results,the cases of BCG lymphoid tuberculosis were divided in to four types:typeⅠ:echo homogeneity type,the pathological manifestation was mainly inflammatory exudation,and there was no obvious damage to the internal structure;typeⅡ:echo inhomogeneity type,the pathological manifestation was typical tuberculosis granuloma,micro-caseous necrotic area could be seen in the center of granuloma;typeⅢ:cystic-solid mass type,the pathological manifestation was atypical granuloma with inhomogeneous thickening in the periphery and caseous necrotic area in the center;typeⅣ:healed calcified type,moreover,the coarse calcified plaques and pathological manifestations were fibrous tissue hyperplasia and necrosis.Conclusion There exists a mass in the ipsilateral axilla or supraclavicular area of infants inoculated with BCG vaccination,and high frequency ultrasound can be used to diagnose BCG vaccination lymphoid tuberculosis,which can be regarded as the prefered examination method for the disease.

关 键 词：超声 婴幼儿 卡介苗 淋巴结结核 诊断 

分 类 号：R522[医药卫生—内科学]