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目的探索腹部淋巴结结核在多层螺旋CT(multi-layered screw CT,MSCT)扫描中CT值动态变化规律。方法 2007年1月—2010年8月,收集经诊断性治疗或诊断性活检确诊的17例患者腹部淋巴结结核,记录肿大淋巴结数量、大小、位置,测量兴趣淋巴结中心、次中心、边缘部平扫及注药后20、60、120、180、360s的CT值。结果共检测出肿大淋巴结269个,主要分布在肝十二指肠韧带、门腔间隙、肝胃韧带、肠系膜根部和腰3平面以上腹主动脉周围,CT值(49.2±13.6)Hu;强化淋巴结215个,选择21个兴趣淋巴结,测得注药20、60、120、180、360s后强化区CT值分别为(67.7±15.3)、(75.2±14.6)、(76.3±18.7)、(75.6±13.4)、(72.6±17.4)Hu。结论腹部淋巴结结核动态CT值表明动脉期明显强化,静脉期及延时扫描强化值维持在动脉期水平呈平台样改变,反映了淋巴结结核慢性感染的病理状态。
Objective To explore the dynamic change of CT value of abdominal lymph node tuberculosis in multi-layered screw CT (MSCT) scans. Methods From January 2007 to August 2010, 17 cases of abdomen lymph node tuberculosis diagnosed by diagnostic treatment or diagnostic biopsy were collected. The number, size and location of lymph nodes were recorded. The lymph node center, sub-center and marginal part were measured Sweep and injection after the CT value of 20,60,120,180,360 s. Results A total of 269 swollen lymph nodes were detected, which were mainly located around the abdominal aorta of the hepatoduodenal ligament, the glenoid space, the hepatic and gastric ligaments, the mesenteric roots and the lumbar 3 plane. The CT value was 49.2 ± 13.6 Hu. 215 lymph nodes and 21 lymph nodes of interest were selected. The CT values of the intensified area were (67.7 ± 15.3), (75.2 ± 14.6), (76.3 ± 18.7) and (75.6 ± 13.4), (72.6 ± 17.4) Hu. Conclusions The dynamic CT value of TB in the nodal lymph nodes shows that the arterial phase is significantly enhanced. The venous phase and delayed-scan enhanced values remain plateau-like in the arterial phase, reflecting the pathological status of chronic infection of lymph node tuberculosis.