组织细胞坏死性淋巴结炎声像图特征及超声诊断价值探讨

目的探讨组织细胞坏死性淋巴结炎(HNL)的高频超声特点,提高超声检出率。方法回顾性分析病理证实的19例HNL、47例结核性淋巴结炎及115例淋巴结反应性增生的声像图特点。结果三组病例在颈部分布区域的差异有统计学意义(P<0.05);HNL组在发病年龄、淋巴结大小、形态(即纵横比)、内部回声、淋巴门结构的检出率、淋巴结边界、内部血流模式、血流分级及血流阻力指数等方面与结核组均有明显的差异(P<0.05),而与增生组相近(P>0.05);HNL组淋巴结周边高回声晕的显示率明显高于其余两组(P<0.05)。结论 HNL声像图特点与结核性淋巴结炎有较大差异,与淋巴结反应性增生相似,但淋巴结周边高回声晕是HNL一个较显著的特征,有助于与其他淋巴结疾病相鉴别。

Value of Ultrasonic Diagnosis and Sonographic Features For Histiocytic Necrotizing Lymphadenitis

Objective To explore the sonographic features of histiocytic necrotizing lymphadenitis(HNL)that can contribute in diagnosing among HNL,tubercular lymphadenitis(TL)and reactive hyperplasia of lymph node(RHL),and to improve its detection rate.Methods The sonographic features of 19 patients with HNL,47 patients with TL and 115 patients with RHL were retrospectively analyzed.Results There were significant differences in cervical levels among HNL group,TL group and RHL group.Compared with TL group,the mean age,mean maximum diameter,shape(T/L),echogenicity,echogenic hilum,border,vascular pattern,blood flow grading and RI in HNL group were significantly different(P<0.05),but similar with RHL group(P>0.05).The hyperechoic rims in HNL group was significantly higher rate than the other groups.Conclusions Sonographic features in HNL group were significant difference than the TL,but similar with RHL,however,hyperechoic rims was a characteristic difference that can contribute to the differentiation between HNL and other causes of cervical lymphadenopathy.