46例颈淋巴结结核超声表现与病理对照研究

目的:对照分析颈部淋巴结结核的声像图表现与病理结果,为临床诊治提供参考信息。方法:分析经手术及病理证实的颈部淋巴结结核46例,并将手术切除区域淋巴结的超声表现与病理对照。结果:46例病变中,Ⅰ型:回声大致均匀6例,病理表现为淋巴结内多发结核性肉芽肿结节,其中伴或不伴有微小干酪坏死;Ⅱ型:回声不均匀15例,其中7例为单一淋巴结内有多个低回声区,病理表现为孤立淋巴结内见多个结核性肉芽肿,中心有干酪坏死;4例超声表现为孤立或贴邻的淋巴结,中央见单发较大低回声区,病理表现为淋巴结边缘为结核性肉芽肿,中央见干酪坏死区融合成片;4例为融合或可疑融合淋巴结,病理表现为多个淋巴结融合或贴邻,伴有周围组织受累,淋巴结内见结核性肉芽肿及干酪坏死;Ⅲ型:正常淋巴结结构消失、中央见大的融合低回声区16例,病理表现淋巴结结构消失,病变中央大片状干酪坏死,边缘见结核性肉芽肿累及周围组织;Ⅳ型:淋巴结缩小,内部为低回声,部分内可见粗大强回声钙化斑9例,病理表现淋巴结内多个干酪坏死区中心的点状钙化灶。结论:超声可清晰显示颈部淋巴结结核各种特征,直接反映其病变各个阶段的病理基础,可作为首选的影像学检查方法。超声表现对疾病的诊断、预后及疗效评价具有重要临床意义。

Comparative analysis 46 cases of ultrasonography of cervical lymph node tuberculosis and pathology

Objective To control the tuberculosis of cervical lymph node sonography and pathologic findings,toprovide reference information for clinical diagnosis and treat-ment.Methods Analysis of pathologically confirmed by surgery and 46 cases of cervical lymph node tuberculosis,and regional lymph node surgery Ultrasound and Pathology.Results 46 patients with lesions,the ultrasound showed echo generally uniform lymph node（I type） 6 cases of pathological lymph nodes showed tuberculous granuloma with multiple nodules,in which small cheese with or without necrosis.Echo heterogeneous lymph node （Ⅱtype） in 15 cases,including seven cases of a single lymph node has a number of low echo area,with isolated lymph node pathology see multiple tuberculous granuloma and central caseous necrosis;four cases of ultrasound with isolated or near to the lymph nodes,see the single large central hypoechoic areas,the edge of the lymph node pathology showed tuberculous granuloma,central see cheese necrosis confluence;four cases of integration of the fusion or suspicious lymph nodes,pathology showed multiple integration or affixed adjacent lymph nodes,accompanied by involvement of surrounding tissue,lymph nodes and cheese see the tuberculous granuloma necrosis. Normal lymph node structure disappeared,the integration of the Central see a large hypoechoic area （Ⅲ） in 16 cases, pathological lymph node structure disappeared,a large slice of cheese central lesion necrosis in tuberculous granulomas involving the edge see the surrounding tissue. Lymph nodes has been reduced,the internal low echo,some cases can see thick hyperechoic calcified plaque （Ⅳ） 9 cases of pathological lymph node necrosis in the center over cheese punctate calcification.Conclusion Ultrasonography can clearly show the various features of cervical lymph node tuberculosis,directly reflects the various stages of the pathological basis of disease.As the preferred imaging method.Ultrasonography on diagnosis,prognosis and treatment evaluation have greater clinical significance.