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目的通过螺旋CT扫描探讨腹部转移性淋巴结与非霍奇金淋巴瘤淋巴结的CT表现及其鉴别诊断。方法回顾性分析腹部淋巴结转移和非霍奇金淋巴结淋巴瘤各30例,测定平扫淋巴结的CT值,记录淋巴结分布区域和强化模式,然后进行统计学分析。入选淋巴结的标准是短径≥1.0 cm,CT值测定方法是选取整个淋巴结为感兴趣区域(ROI),每个病例任意选取1~2个淋巴结测定。结果平扫CT值,腹部非霍奇金淋巴瘤与淋巴结转移瘤比较差异有显著性(t=7.216,P<0.01),前者的均值为(40.15±4.29)HU,后者的均值为(32.53±5.19)HU;强化模式比较,两者在周边强化方面差异有显著性,转移性淋巴结周边强化明显多于淋巴瘤淋巴结。转移性淋巴结40.0%(12/30)为周边强化;非霍奇金淋巴瘤淋巴结(本组均为未治)10.0%(3/30)周边强化。优势分布区域方面,转移性淋巴结优势分布于腹主动脉上区、小网膜、肠系膜及肾旁前间隙;非霍奇金淋巴瘤淋巴结主要分布于腹主动脉上下区、肠系膜区、肾旁前间隙以及小网膜区域。两者在腹主动脉下区分布比较差异有显著性(2χ=48.654,P<0.01),非霍奇金淋巴瘤淋巴结在该区分布明显多于肿瘤转移性淋巴结。结论利用螺旋CT分别从淋巴结的CT值、强化模式及优势分布区域等方面可以总结出腹部转移性淋巴结和非霍奇金淋巴瘤淋巴结的征象,并对两者作出一定的鉴别诊断。
Objective To investigate the CT findings and differential diagnosis of lymph node metastases between abdomen and non-Hodgkin’s lymphoma by spiral CT scan. Methods The clinical data of 30 cases with lymph node metastasis and non-Hodgkin’s lymphoma were retrospectively analyzed. The CT value of lymph node was measured, and the distribution of lymph nodes and enhancement pattern were recorded. Then the statistical analysis was made. Selected lymph nodes standard is short diameter ≥ 1.0 cm, CT value determination method is to select the entire lymph node is the region of interest (ROI), each case randomly selected 1-2 lymph node measurements. Results The CT value of abdominal plain non-Hodgkin’s lymphoma and lymph node metastasis had significant difference (t = 7.216, P <0.01), the average value of the former was (40.15 ± 4.29) HU and the latter was (32.53 ± 5.19) HU. Compared with the enhancement mode, the differences between the two groups in peripheral enhancement were significant, and the peripheral enhancement of metastatic lymph nodes was significantly more than that of lymphatic nodes. Metastatic lymph nodes 40.0% (12/30) peripheral enhancement; non-Hodgkin’s lymph node lymph nodes (this group were not treated) 10.0% (3/30) peripheral enhancement. Advantages of the distribution area, the distribution of metastatic lymph nodes in the superior abdominal aorta, the lesser omentum, mesenteric and renal anterior space; non-Hodgkin’s lymphoma lymph nodes are mainly located in the upper and lower abdominal aorta, mesenteric area, Gaps and small retinal areas. There was a significant difference between the two groups in the distribution of abdominal aorta (2χ = 48.654, P <0.01). The non-Hodgkin’s lymph node distribution in this area was significantly more than that in metastatic lymph nodes. Conclusion The CT findings of lymph node and non-Hodgkin’s lymphoma of lymph nodes can be summarized from the CT value of lymph nodes, the enhancement mode and the distribution of dominant lymph nodes by spiral CT, and to make some differential diagnosis between the two.