胰周淋巴结结核MSCT诊断价值分析  

Analysis of the Diagnostic Value of MSCT in Peripancreatic Lymph Node Tuberculosis

作　　者：刘松涛 张瑜 刘会佳 侯炜寰 文娣娣 杨丽 张劲松 郑敏文 唐永强 LIU Songtao;ZHANG Yu;LIU Huijia(Department of Radiology,Xijing Hospital,Xi′an,Shaanxi Province 710032,P.R.China)

机构地区：[1]空军军医大学西京医院放射科,西安710032 [2]空军军医大学西京医院病理科,西安710032

出　　处：《临床放射学杂志》2023年第4期611-617,共7页Journal of Clinical Radiology

摘　　要：目的探讨胰周淋巴结结核的多层螺旋CT(MSCT)表现特征,分析MSCT在胰周淋巴结结核诊断中应用价值。方法回顾性分析33例经手术或穿刺组织病理学证实,且结核感染T细胞斑点试验(T-SPOT.TB)阳性胰周淋巴结结核患者的影像学及临床资料,33例均行CT平扫及增强扫描,其中2例同时行MRI扫描。结果33例患者中4例仅累及13组(胰头后淋巴结)淋巴结,29例累及多组淋巴结区。25例CT平扫表现为胰周结节状、团块状低密度影,密度不均,部分融合,增强扫描呈边缘环形强化,内部呈渐进性“分隔样”及“蜂窝样”强化。3例CT平扫表现为胰周软组织结节影,边界清楚,增强扫描呈轻中度渐进性强化。5例CT平扫病灶内伴有结节状、斑片状钙化。结论胰周淋巴结结核MSCT表现有一定特征性,结合临床表现以及实验室检查可做出较准确的诊断。Objective To investigate the MSCT imaging features of peripancreatic lymph node tuberculosis and analysis the value of MSCT in the diagnosis of peripancreatic lymph node tuberculosis.Methods The CT images and clinical data of 33 patients with peripancreatic lymph node tuberculosis proved by operation or pathology,and positive for T⁃cell spot test for tuberculosis infection were reviewed retrospectively.All cases underwent noncontrast and contrast enhanced CT scans.Two cases underwent MRI scans.Results Four out of thirty⁃three patients only involved thirteen station lymph nides(lymph nodes behind the head of the pancreas);Twenty⁃nine patients involved muptiple groups of lymph nodes.Twenty⁃five patients showed peripancreatic low⁃density nodular or mass on CT noncontrast enhanced scan,with uneven density and par⁃tial fusion.The contrast enhanced CT scan showed annular enhancement at the edge,and progressive“separation⁃like”and“honeycomb⁃like”enhancement in the interior.Three patients showed peripancreatic soft tissue nodules with clear boeders on CT noncontrast enhancement scan,and contrast enhancement showed mild to moderate progressive enhancement.Five pa⁃tients showed nodular and patchy calsification on CT noncontrast enhancement scan.Conclusion The CT manifestations of peripancreatic lymph node tuberculosis has certain characteristics,and a more accurate diagnosis can be made in combi⁃nation with clinical manifestations.

关 键 词：胰周 淋巴结结核 体层摄影术 X线计算机 

分 类 号：R525[医药卫生—内科学] R816[医药卫生—临床医学]