颈部淋巴结病变在MSCT中的影像学特征及鉴别诊断价值研究  

Study on The Imaging Characteristics and Differential Diagnostic Value of Cervical Lymphadenopathy in MSCT

作　　者：何丽[1] 王颖[1] 王正营 He Li;Wang Ying;Wang Zheng-ying(CT Room of Radiology Department,Nanyang First People's Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市第一人民医院放射科CT室,河南南阳473000

出　　处：《罕少疾病杂志》2023年第6期28-29,共2页Journal of Rare and Uncommon Diseases

摘　　要：目的 探究颈部淋巴结病变在多层螺旋CT(MSCT)中的影像学特征及鉴别诊断价值。方法 选南阳市第一人民医院CT室2021年1月至12月期间80例颈部淋巴结病变患者为研究对象,以病理标准将其分为淋巴瘤组(33例)、淋巴结转移瘤组(47例),并选60例同期健康体检者设为对照组,均应用MSCT检查,比较其影像学特征及检出结果 差异性。结果 淋巴瘤组33例患者中,共检出49个病变淋巴结;淋巴结转移瘤组47例患者中,共检出61个病变淋巴结;血流量(BF)水平:淋巴瘤组>淋巴结转移瘤组>对照组,差异有统计学意义(P<0.05);病灶坏死率:淋巴结转移瘤组>淋巴瘤组(50.82%vs14.29%),差异有统计学意义(P<0.05);坏死病灶强化类型中,厚环状强化占比:淋巴结转移瘤组>淋巴瘤组(22.95%vs2.04%);不均匀强化占比:淋巴结转移瘤组<淋巴瘤组(8.20%vs22.45%),差异有统计学意义(P<0.05);薄环状强化、融合坏死占比:淋巴结转移组与淋巴瘤组相近(4.92%vs6.12%)、(3.28%vs0.00%),差异无统计学意义(P>0.05)。影像学征象:(1)淋巴瘤:病灶多发性;病灶直径一般>1.5cm;坏死病灶相对较少;单发病灶多见颈淋巴结群融合呈块状;(2)淋巴结转移瘤:主要分布在颈静脉链周围,淋巴结主要表现为周围增厚强化,中心区域呈现低密度无强化坏死区。结论 颈部淋巴结病变会出现血流量增强变化,且与淋巴结转移瘤相比,淋巴瘤血流量水平升高,坏死病灶检出率下降,坏死病灶中以不均匀强化、不规则坏死病灶为主,淋巴结转移瘤以厚环状强化多见。Objective To explore the imaging characteristics and differential diagnostic value of cervical lymphadenopathy in multi-layer spiral CT(MSCT).Methods In the CT room of Nanyang First People's Hospital from January to December 2021,it was divided into lymphoma group(33 cases)and lymph node metastasis group(47 cases),and 60 patients with health examination during the same period were selected as the control group,and MSCT examination was used to compare the imaging characteristics and detection results.Results In the 33 patients in the lymphoma group,A total of 49 diseased lymph nodes were detected;Of the 47 patients in the lymph node metastasis group,A total of 61 diseased lymph nodes were detected;Blood flow(BF)levels:lymphoma group>lymph node metastasis group>control group,The difference was statistically significant(P<0.05);Lesion necrosis rate:lymph node metastasis group>lymphoma group(50.82%vs14.29%),The difference was statistically significant(P<0.05);In the intensified type of necrotic lesions,Proportion of thick ring enhancement:lymph node metastasis group>lymphoma group(22.95%vs2.04%);The portion of uneven enhancement:lymph node metastasis group<lymphoma group(8.20%vs22.45%),The difference was statistically significant(P<0.05);Proportion of thin ring enhancement and fusion necrosis:lymph node metastasis group was similar to lymphoma group(4.92%vs6.12%),(3.28%vs0.00%),There was no statistically significant difference(P>0.05).Imaging signs:(1)Lymphoma:multiple lesions;lesion diameter generally>1.5cm;relatively few necrotic lesions;single lesions mostly massive fusion of cervical lymph nodes;(2)lymph node metastases:mainly distributed around the jugular vein chain,lymph nodes mainly showed thickening of surrounding enhancement,low density in the central area.Conclusion The cervical lymph node lesions will have enhanced blood flow changes,and compared with lymph node metastases,the blood flow level of lymphoma increased,and the detection rate of necrotic lesions decreased.In necrotic lesions,uneven strengtheni

关 键 词：淋巴瘤 淋巴结转移瘤 多层螺旋CT 

分 类 号：R551.2[医药卫生—血液循环系统疾病]