湖南师范大学学报（医学版）
湖南師範大學學報（醫學版）
호남사범대학학보（의학판）
Journal of Hunan Normal University (Medical Science)
2015年
5期
86-87,88
,共3页
孟艳枝%张强%孙利杰%邵建波
孟豔枝%張彊%孫利傑%邵建波
맹염지%장강%손리걸%소건파
淋巴结%结核%超声%病理
淋巴結%結覈%超聲%病理
림파결%결핵%초성%병리
Lymph node%tuberculosis%ultrasound%pathology
目的：探讨颈部淋巴结结核超声图像表现及病理结果，以及超声诊断颈部淋巴结的诊断价值。方法：选取2012年3月至2014年5月在我院治疗的疑似颈部淋巴结结核患者138例，经病理证实102例。观察比较超声图像表现及病理结果。结果：超声诊断的灵敏度（SEN）为77.45%，95%CI为69.34%～85.56%，特异度为（SPE）55.56%，95%CI为39.32%～71.79%，阳性预测值（PV+）为83.16%，95%CI为75.63%～90.68%，阴性预测值（PV-）为46.51%，95%CI为31.60%～61.42%，Youden指数为0.330，95%CI为0.149～0.512；42例超声图像Ⅰ型（实质型）显示内部回声均匀，大小约0.4～2.3cm，病理表现为多个结核肉芽肿结构，肉芽肿中心可见微小干酪样坏死区；Ⅱ型（囊实混合型）有39例，显示中部不规则回声区，内壁不均匀增厚，病理表现为不典型的肉芽肿病变，中央可见大片融合干酪样坏死区；Ⅲ型（钙化型）有21例，显示长条状或斑块样强回声钙化区，病理表现为纤维组织增生、坏死和（或）结核性肉芽肿。结论：超声诊断颈部淋巴结结核的诊断价值尚可，颈部淋巴结结核超声表现可直接反映淋巴结结核病变各个阶段的病理基础。
目的：探討頸部淋巴結結覈超聲圖像錶現及病理結果，以及超聲診斷頸部淋巴結的診斷價值。方法：選取2012年3月至2014年5月在我院治療的疑似頸部淋巴結結覈患者138例，經病理證實102例。觀察比較超聲圖像錶現及病理結果。結果：超聲診斷的靈敏度（SEN）為77.45%，95%CI為69.34%～85.56%，特異度為（SPE）55.56%，95%CI為39.32%～71.79%，暘性預測值（PV+）為83.16%，95%CI為75.63%～90.68%，陰性預測值（PV-）為46.51%，95%CI為31.60%～61.42%，Youden指數為0.330，95%CI為0.149～0.512；42例超聲圖像Ⅰ型（實質型）顯示內部迴聲均勻，大小約0.4～2.3cm，病理錶現為多箇結覈肉芽腫結構，肉芽腫中心可見微小榦酪樣壞死區；Ⅱ型（囊實混閤型）有39例，顯示中部不規則迴聲區，內壁不均勻增厚，病理錶現為不典型的肉芽腫病變，中央可見大片融閤榦酪樣壞死區；Ⅲ型（鈣化型）有21例，顯示長條狀或斑塊樣彊迴聲鈣化區，病理錶現為纖維組織增生、壞死和（或）結覈性肉芽腫。結論：超聲診斷頸部淋巴結結覈的診斷價值尚可，頸部淋巴結結覈超聲錶現可直接反映淋巴結結覈病變各箇階段的病理基礎。
목적：탐토경부림파결결핵초성도상표현급병리결과，이급초성진단경부림파결적진단개치。방법：선취2012년3월지2014년5월재아원치료적의사경부림파결결핵환자138례，경병리증실102례。관찰비교초성도상표현급병리결과。결과：초성진단적령민도（SEN）위77.45%，95%CI위69.34%～85.56%，특이도위（SPE）55.56%，95%CI위39.32%～71.79%，양성예측치（PV+）위83.16%，95%CI위75.63%～90.68%，음성예측치（PV-）위46.51%，95%CI위31.60%～61.42%，Youden지수위0.330，95%CI위0.149～0.512；42례초성도상Ⅰ형（실질형）현시내부회성균균，대소약0.4～2.3cm，병리표현위다개결핵육아종결구，육아종중심가견미소간락양배사구；Ⅱ형（낭실혼합형）유39례，현시중부불규칙회성구，내벽불균균증후，병리표현위불전형적육아종병변，중앙가견대편융합간락양배사구；Ⅲ형（개화형）유21례，현시장조상혹반괴양강회성개화구，병리표현위섬유조직증생、배사화（혹）결핵성육아종。결론：초성진단경부림파결결핵적진단개치상가，경부림파결결핵초성표현가직접반영림파결결핵병변각개계단적병리기출。
ObjectiveExplore the cervical lymph node tuberculosis ultrasound image manifestations and pathological re-sults, and the diagnostic value of ultrasonic diagnosis of cervical lymph nodes.Methods Selection in March 2012 to May 2014 in our hospital treatment of suspected patients with cervical lymph node tuberculosis, compare ultrasonic image manifestations and pathological results.ResultsUltrasonic diagnostic sensitivity (SEN) was 77.45%, 95% CI is 69.34%~85.56%, and specif-ic degree is 55.56% (SPE), 95% CI is 39.32%~71.79%, positive predictive value (PV+) 83.16%, 95% CI is 75.63%~90.68%, negative predictive value (PV-) is 46.51%, 95% CI is 31.60%~61.42%, Youden index was 0.330, 95% CI 0.149 to 0.149; 42 cases of type ultrasonic imageⅠuniform (substance) shows the internal homogeneous echo, the size is about 0.4~2.3 cm, pa-thology showed multiple tuberculous granuloma structure, granuloma center visible tiny caseous necrosis region; Type II (cystic solid mixed type) in 39 cases, showed irregular echo area in central area, inner wall irregular thickening, pathological mani-festations showed atypical granulomatous lesion, seen in the middle of large fusion caseous necrosis region; Type III (calcifica-tion) in 21 cases, display strip or patch like the strong echo area of calcification, pathology showed fibrous tissue hyperplasia, necrosis and (or) of tuberculous granuloma.ConclusionUltrasound diagnosis of cervical lymph node tuberculosis has certain value,sonographic findings of cervical lymph node tuberculosis can directly reflect the pathogenesis of various stages of lymph node tuberculosis.
