成人腹部淋巴结结核动态CT值分析

【】　目的　探索腹部淋巴结结核在多层螺旋CT（multi-layeredscrewCT，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。【Abstract】　Objective　ToexplorethechangingruleofdynamicCTvaluesforabdominallymphnodetuberculosisinmulti-layeredscrewCT(MSCT)multiphasicscanning.　Methods　BetweenJanuary2007andAugust2010,17casesofabdominallymphnodetuberculosisconfirmedbydiagnosistreatmentordiagnosisbiopsywereretrospectivelyanalyzed.Thequantity,sizeandpositionofthelymphnodeswererecorded,andCTplainscanningvaluesoftheinterestedlymphnodecenter,subcenter,andthemarginofthenode,andtheCTvalues20,60,120,180and360secondsafterdrugadministrationwerealsomeasured.　Results　Enlargementwasfoundin269lymphnodeswhichweremainlydistributedintheliverduodenumligament,thegatecavitygap,thehepatogastricligament,themesenteryrootandthenodesinretroperitonealspaceabovethethirdlumbarvertebra.TheaverageCTvaluewas(49.2±13.6)Hu.Atotalof215lymphnodeshadstrengthenedmanifestations,and21interestedlymphnodeswerechosenforthestudy.TheaverageCTvaluesforlymphnodeswithstrengthenedmanifestations20,60,120,180,and360secondsafterdrugadministrationwererespectively(67.7±15.3),(75.2±14.6),(76.3±18.7),(75.6±13.4),and(72.6±17.4)Hu.　Conclusion　DynamicCTvalueofabdominallymphnodetuberculosisshowsastrengtheninginthearterialphase,andthevaluesinthethevenousphaseandthedelayedphasemaintainatthearterialphaselevel,anddonotchange,whichindicatesapathologicalstateofchronicinfectionofthelymphnodetuberculosis.