【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.
ObjectiveTo investigate surgical indications and techniques of video-assisted thoracoscopic surgery (VATS) for mediastinal lymph node tuberculosis. MethodsClinical data of 27 patients who underwent VATS for mediastinal lymph node tuberculosis between January 2010 and March 2013 in Wuhan Medical Treatment Center were retrospectively analyzed. There were 16 male and 11 female patients with their age of 18-67 (30.23±10.72) years. ResultsThere was no in-hospital death. Postoperative complications included recurrent laryngeal nerve injury in 1 patient, delayed wound healing in 1 patient and pneumothorax in 1 patient. Postoperatively, all the patients received intensified anti-tubercular treatment, and were engaged in normal physical activities during follow-up of 6 months. ConclusionVATS is safe and reliable for the treatment of mediastinal lymph node tuberculosis, and anti-tubercular treatment is needed before and after the operation.