摘要
目的探讨艾滋病(AIDS)患者颈部淋巴结结核(CTL)的CT诊断及鉴别诊断。方法回顾性分析经颈部淋巴结取材活检证实病因的AIDS并颈部淋巴结肿大患者的颈部CT资料,总结AIDS并CTL的CT特征,提高对其CT诊断与鉴别诊断能力。结果 70例AIDS病人中CTL 39例,马尔尼菲篮状菌(TM)病4例,AIDS相关性淋巴结病4例,慢性淋巴结炎1例,AIDS相关性淋巴结病合并CTL、TM病1例,淋巴结转移瘤(LNM)10例,非霍奇金淋巴瘤(NHL)10例,卡波西肉瘤1例。21/22CTL可出现环形强化;4例TM病均表现为稍低密度淋巴结肿大;4例AIDS相关性淋巴结病3例为均匀密度淋巴结肿大;LNM均匀软组织密度淋巴结肿大较CTL多见(fisher精确检验,P=0.04),且最大径常>CTL(t=-2.228,P=0.05);NHL最大径常>CTL(t=-3.78,P<0.01),差异有统计学意义。增强扫描CTL出现环形强化率(21/22)较LNM(2/6)、NHL(1/6)高,差异有统计学意义(fisher精确检验,P<0.01)。结论 AIDS并CTL的CT表现多样,增强扫描多为环形强化;肿大淋巴结的CT表现对AIDS并CTL的诊断及鉴别诊断具有重要作用。
Objective To explore CT diagnosis and differential diagnosis of cervical tuberculous lymphadenitis(CTL)in AIDS patients.Methods The CT data of 70 patients with AIDS and cervical lymph node enlargement confirmed by biopsy was retrospectively analyzed to summarize the CT features of CTL in AIDS patients to improve the quality of CT diagnosis and differential diagnosis.Results Among the 70 AIDS cases,there were 39 cases with CTL,4 cases with TM,4 cases with AIDS-related lymphadenopathy,1 case with chronic lymphadenopathy,1 case with AIDS-related lymphadenopathy with CTL and TM,10 cases with NHL,10 cases with LNM,and 1 case with Kaposi′s sarcoma.95.5%(21/22)of CTL showed circular enhancement.Four cases of TM disease mostly showed slightly low density lymphadenopathy,4 cases presented AIDS-related lymphadenopathy and 3 cases showed homogeneous density lymphadenopathy.LNM had more homogeneous soft tissue density lymphadenopathy than that of CTL(fisher′s exact test,P=0.04),and the maximum diameter was greater than CTL(t=-2.228,P=0.05).The maximum diameter of NHL was significantly higher than that of CTL(t=-3.78,P<0.01).The circular enhancement rate(95.5%,21/22)of enhanced CTL was higher than that of LNM(33.3%,2/6)and NHL(16.7%,1/6),with the difference statistically significant(fisher exact test,P<0.01).Conclusion AIDS patients complicated with CTL shows that multiple manifestations and enhanced scanning is ring enhancement.CT findings of enlarged lymph nodes play an important role in the diagnosis and differential diagnosis of cervical tuberculous lymphadenitis in AIDS patients.
作者
宋树林
卢亦波
莫移美
张世迁
黎瑜
彭认平
曾自三
SONG Shulin;LUYibo;MO Yimei;ZHANG Shiqian;LI Yu;PENG Renping;ZENG Zisan(Department of Radiology,the Fourth People′s Hospital of Nanning,Nanning 530023,China;Endoscopic Laboratory,the Fourth People′s Hospital of Nanning,Nanning 530023;Department of Radiology,the First Hospital Affiliated to Guangxi Medical University,Nanning 530021)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2019年第8期787-790,共4页
Chinese Journal of Aids & STD
基金
广西自然科学基金项目(2014GXNSFAA118192)
南宁市科学研究与技术开发计划项目(20173157-6)
兴宁区科学研究与技术开发项目(2018A06)~~
关键词
艾滋病
颈部
淋巴结
诊断
AIDS
Cervical
Lymph nodes
Diagnosis
作者简介
第一作者简介:宋树林(1985-),男,江西省赣州市人,硕士,主治医师,研究传染病学影像;通信作者:曾自三,主任医师,硕士研究生导师,Emai:1172276528@qq.com
