乙型肝炎患者肝门区淋巴结肿大的超声诊断价值

目的探讨病毒性肝炎(乙型)患者肝门区淋巴结肿大的诊断及临床意义。方法常规超声检查37例住院乙肝患者,被检者肝门区清晰显示肿大淋巴结后,观察并记录肿大淋巴结数目、大小、分布范围及内部血流信号,测量胆囊壁厚度,并摄片保存。结果超声显示淋巴结肿大1个(5例),2个(16例),3个(10例),4个及以上(6例)。淋巴结长径14～30 mm,平均18 mm,位于门脉主干、肝动脉周围及肝胃韧带间,以门脉主干周围多见;淋巴结呈卵圆形,包膜完整,边界清晰,以低回声为主,回声欠均匀,比较孤立,内见少量点状血流信号。结论病毒性肝炎(乙型)可以引起肝门区淋巴结肿大,且与血清肝功能变化及病变程度有一定关系,可作为病毒性肝炎肝外系统声像图改变的又一观察指标。

Ultrasonic Diagnosis of Portal Lymphadenopathy in Patients with Type B Hepatitis

Objective To evaluate the ultrasonic diagnosis of the portal lymphadenopathy in patients with type B hepatitis.Methods Total 37 patients with type B hepatitis received routine ultrasonography.For the cases with clearly enlarged lymph nodes in hilar,the number,size,distribution range,blood flow signal inside the nodes and thickness of gallbladder wall were measured and recorded.Results Five cases were with 1,16 cases with 2,10 cases with 3 and 6 cases with 4 enlarged lymph node.The major axis was 14 to 30 mm(mean 18 mm).The enlarged lymph nodes widely distributed in the trunk of portal venous(more common),around hepatic artery or gastrohepatic ligament.The lymph nodes were orbicular-ovate,lower echo than liver and isolated with integrated envelope and clean bordline.The blood flow signal inside the nodes was spotty signals.Conclusion Type B hepatitis may result in the portal lymphadenopathys.The portal lymphadenopathy has relationship with the hepatic function and pathological changes,and can used as an espial guideline of ultrasonic images to the diagnosis of type B hepatitis.