Dynamic CT Value Analysis of Abdominal Lymph Node Tuberculosis in Adult_West China Medical Journal

Authors：

CHEN Zhubi , ZUO Wen , HE Jun , ZENG Yunfu , YANG Xiangchun , HE Xiaodong

Department of Radiology, Yibin First People’s Hospital, Yibin, Sichuan 644000, P. R. China;

Corresponding author：

Keywords：

腹部; 淋巴结结核; 体层摄影术; CT值

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

【摘要】　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、360 s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、360 s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。
【Abstract】　Objective　 To explore the changing rule of dynamic CT values for abdominal lymph node tuberculosis in multi-layered screw CT (MSCT) multiphasic scanning. 　Methods　 Between January 2007 and August 2010, 17 cases of abdominal lymph node tuberculosis confirmed by diagnosis treatment or diagnosis biopsy were retrospectively analyzed. The quantity, size and position of the lymph nodes were recorded, and CT plain scanning values of the interested lymph node center, subcenter, and the margin of the node, and the CT values 20, 60, 120, 180 and 360 seconds after drug administration were also measured. 　Results　 Enlargement was found in 269 lymph nodes which were mainly distributed in the liver duodenum ligament, the gate cavity gap, the hepatogastric ligament, the mesentery root and the nodes in retroperitoneal space above the third lumbar vertebra. The average CT value was (49.2±13.6) Hu. A total of 215 lymph nodes had strengthened manifestations, and 21 interested lymph nodes were chosen for the study. The average CT values for lymph nodes with strengthened manifestations 20 ,60, 120, 180, and 360 seconds after drug administration were respectively (67.7±15.3), (75.2±14.6), (76.3±18.7), (75.6±13.4), and (72.6±17.4) Hu. 　Conclusion　 Dynamic CT value of abdominal lymph node tuberculosis shows a strengthening in the arterial phase, and the values in the the venous phase and the delayed phase maintain at the arterial phase level, and do not change, which indicates a pathological state of chronic infection of the lymph node tuberculosis.

Citation： CHEN Zhubi,ZUO Wen,HE Jun,ZENG Yunfu,YANG Xiangchun,HE Xiaodong. Dynamic CT Value Analysis of Abdominal Lymph Node Tuberculosis in Adult. West China Medical Journal, 2011, 26(5): 707-709. doi: Copy

1.	Dorfman RE, Alpern MB, Gross BH, et al. Upper abdominal lymph nodes criteria for normal size determined with CT[J]. Radiology, 1991, 180(2): 319-322.
2.	同济医科大学病理学教研室, 中山医科大学病理学教研室. 外科病理学[M]. 2版. 武汉: 湖北科学技术出版社, 1999: 582-583.
3.	李媛, 杨志刚, 闵鹏秋, 等. 腹腔、腹膜后淋巴结结核与淋巴瘤的多层螺旋CT鉴别诊断[J]. 中国医学影像技术, 2005, 21(8): 1252-1255.
4.	吕明德, 杨建勇. 腹部外科影像诊断与介入治疗学[M]. 北京: 人民卫生出版社, 2003: 368.
5.	Yang ZG, Min PQ, Sone S, et al. Tuberculosis versus lymphomas in the abdominal lymph nodes: evaluation with contrast-enhanced CT[J]. AJR, 1999, 172(3): 619-623.
6.	Yang ZG, Min PQ, Sone S, et al. Distribution and contrast-enhanced CT appearance of abdominal tuberculosis lymphadenopathy[J]. Nippon Acta Radiologica, 1997, 57(9): 567-571.
7.	杨志刚, 闵鹏秋, 余建群, 等. 血行播散型结核累及腹部器官的CT强化特征及其优势解剖分布[J]. 临床放射学杂志, 2004, 23(3): 218-221.
8.	韦建林, 滕才钧, 廖明壮, 等. 腹部淋巴结结核的CT分析[J]. 实用医学杂志, 2008, 24(10): 1849.
9.	孙伟英, 袁建华, 丁忠祥, 等. 腹部淋巴结结核的CT诊断[J]. 放射学实践, 2009, 24(6): 654.
10.	Pereira JM, Madureira AJ, Vieira A, et al. Abdominal tuberculosis: imaging features[J]. Eur J Radiol, 2005, 55(2): 173-180.
11.	Akcam M, Artan R, Yilmaz A, et al. Abdominal tuberculosis in adolescents. Difficulties in diagnosis[J]. Saudi Med J, 2005, 26(1): 122-126.
12.	Sen M, Turan M, Karadayi K, et al. Peripancreatic tuberculous lymphadenitis mimicking carcinoma: report of a case[J]. Acta Chir Belg, 2004, 104(3): 338-340.
13.	Khan R, Abid S, Jafri W, et al. Diagnostic dilemma of abdominal tuberculosis in non-HIV patients: an ongoing challenge for physicians[J]. World J Gastroenterol, 2006, 12(39): 6371-6375.
14.	贺海荣, 张旻, 刘甫庚, 等. 胸腹部淋巴结结核18F-FDG PET/CT显像1例[J]. 中国临床医学影像杂志, 2010, 21(9): 680.
15.	李天兴, 汤中文, 倪正义. 病灶清除术治疗腹部淋巴结结核50例疗效分析[J]. 实用临床医学, 2010, 11(9): 40.

1. 　Dorfman RE, Alpern MB, Gross BH, et al. Upper abdominal lymph nodes criteria for normal size determined with CT[J]. Radiology, 1991, 180(2): 319-322.
2. 　同济医科大学病理学教研室, 中山医科大学病理学教研室. 外科病理学[M]. 2版. 武汉: 湖北科学技术出版社, 1999: 582-583.
3. 　李媛, 杨志刚, 闵鹏秋, 等. 腹腔、腹膜后淋巴结结核与淋巴瘤的多层螺旋CT鉴别诊断[J]. 中国医学影像技术, 2005, 21(8): 1252-1255.
4. 　吕明德, 杨建勇. 腹部外科影像诊断与介入治疗学[M]. 北京: 人民卫生出版社, 2003: 368.
5. 　Yang ZG, Min PQ, Sone S, et al. Tuberculosis versus lymphomas in the abdominal lymph nodes: evaluation with contrast-enhanced CT[J]. AJR, 1999, 172(3): 619-623.
6. 　Yang ZG, Min PQ, Sone S, et al. Distribution and contrast-enhanced CT appearance of abdominal tuberculosis lymphadenopathy[J]. Nippon Acta Radiologica, 1997, 57(9): 567-571.
7. 　杨志刚, 闵鹏秋, 余建群, 等. 血行播散型结核累及腹部器官的CT强化特征及其优势解剖分布[J]. 临床放射学杂志, 2004, 23(3): 218-221.
8. 　韦建林, 滕才钧, 廖明壮, 等. 腹部淋巴结结核的CT分析[J]. 实用医学杂志, 2008, 24(10): 1849.
9. 　孙伟英, 袁建华, 丁忠祥, 等. 腹部淋巴结结核的CT诊断[J]. 放射学实践, 2009, 24(6): 654.
10. 　Pereira JM, Madureira AJ, Vieira A, et al. Abdominal tuberculosis: imaging features[J]. Eur J Radiol, 2005, 55(2): 173-180.
11. 　Akcam M, Artan R, Yilmaz A, et al. Abdominal tuberculosis in adolescents. Difficulties in diagnosis[J]. Saudi Med J, 2005, 26(1): 122-126.
12. 　Sen M, Turan M, Karadayi K, et al. Peripancreatic tuberculous lymphadenitis mimicking carcinoma: report of a case[J]. Acta Chir Belg, 2004, 104(3): 338-340.
13. 　Khan R, Abid S, Jafri W, et al. Diagnostic dilemma of abdominal tuberculosis in non-HIV patients: an ongoing challenge for physicians[J]. World J Gastroenterol, 2006, 12(39): 6371-6375.
14. 　贺海荣, 张旻, 刘甫庚, 等. 胸腹部淋巴结结核18F-FDG PET/CT显像1例[J]. 中国临床医学影像杂志, 2010, 21(9): 680.
15. 　李天兴, 汤中文, 倪正义. 病灶清除术治疗腹部淋巴结结核50例疗效分析[J]. 实用临床医学, 2010, 11(9): 40.

West China Medical Journal

Dynamic CT Value Analysis of Abdominal Lymph Node Tuberculosis in Adult

Abstract Full text Figures/Tables Video References Cited by

Format

Content