超声评估Kikuchi-Fujimoto病患者的浅表淋巴结

目的分析Kikuchi-Fujimoto病(KFD)累及浅表淋巴结的灰阶超声及彩色多普勒超声表现。方法对22例经病理证实的KFD患者的受累浅表淋巴结进行常规灰阶和彩色多普勒超声检查,分别观察淋巴结的位置、数目、大小、形态、边界、皮质回声、淋巴门结构、周围组织及血管模式。结果 22例患者共评估54个淋巴结。淋巴结横径为0.5～2.2cm,平均(1.0±0.4)cm,纵径为0.8～4.3cm,平均(1.9±0.8)cm。68.52%(37/54)形态呈圆形,51.85%(28/54)边界锐利,皮质均呈低回声(54/54,100%),53.70%(29/54)淋巴门消失,46.30%(25/54)淋巴结周边可见回声增高区,88.89%(48/54)血管模式呈淋巴门型。结论 KFD累及浅表淋巴结时,部分受累淋巴结的灰阶超声表现与恶性淋巴结相似,血管模式与反应性淋巴结相似,而淋巴结周边回声增高可能有助于与其他淋巴结病变相鉴别。

Ultrasound evaluation on superficial lymph nodes in patients with Kikuchi-Fujimoto disease

Objective To analyze the gray-scale and color Doppler ultrasonic features of superficial lymphadenopathy in patients with Kikuchi-Fujimoto disease (KFD). Methods Twenty-two patients with KFD confirmed with pathology were reviewed. On grey-scale ultrasound, lymph nodes were assessed by the distribution, number, size, shape, border, echogenicity, echogenic nodal hilum and structures surrounding the nodes. The vascular pattern of the nodes was assessed with color Doppler ultrasound. Results The maximum transverse and longitudinal diameters of all 54 lymph nodes in 22 patients were 0.5-2.2 cm with the average value of (1.0±0.4)cm and 0.8-4.3 cm with the average value of (1.9±0.8)cm, respectively. The affected nodes were hypoechoic (54/54, 100%), tended to have a round shape (37/54, 68.52%), a sharp border (28/54, 51.85%) and no echogenic hilus (29/54, 53.70%). Increased perinodal echogenicity was seen in 25 (25/54, 46.30%) nodes. On color Doppler ultrasound, most of these nodes showed hilar vascularity (48/54, 88.89%). Conclusion Superficial lymph nodes involved with KFD show several malignant-favoring features on grey-scale ultrasound. The vascular pattern is similar to reactive nodes. Increased perinodal echogenicity may be useful for the differentiation of KFD from cervical lymphadenopathy caused by other diseases.