Department of Radiology, University Medical Center Utrecht and Wilhelmina Children's Hospital, HP E.01.132, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Eur Radiol. 2012 Feb;22(2):318-21. doi: 10.1007/s00330-011-2253-9. Epub 2011 Sep 2.
To study normal mediastinal and hilar lymph nodes on multi-detector chest computed tomography (CT).
A cohort of 120 children aged 1-17 years underwent emergency CT, including the chest, after high-energy trauma. Axial 5-mm reconstructions were evaluated for lymph nodes at hilar and various mediastinal levels and the short-axis diameters were measured.
At least one lymph node was found in 115 (96%) children, with subcarinal (69%), lower paratracheal (64%) and hilar (60%) nodes being most common. Up to 10 years of age most lymph nodes were smaller than or equal to 7 mm. In older children lymph nodes measuring up to 10-mm-short-axis diameter were found. Lymph nodes were rare along the mammary vessels, at lower oesophageal and at prevascular and posterior mediastinal levels in children.
Mediastinal and hilar lymph nodes are more common than previously thought, probably because of increased detection by modern multi-detector CT. Lymph node location and age have to be taken into account when evaluating lymph nodes in the paediatric chest. Key Points • The size and location of normal lymph nodes is of great diagnostic importance • There is little relevant published information related to pediatric chest computed tomography • We provide normative data concerning mediastinal and hilar lymph nodes in children • These normal values can help identify abnormal lymph nodes in children.
研究多排胸部 CT 检查中正常纵隔和肺门淋巴结的表现。
本队列纳入 120 例年龄 1-17 岁的因高能外伤行急诊胸部 CT 检查的患儿，评估包括横轴位 5mm 重建图像上肺门和各纵隔层面的淋巴结，并测量短轴直径。
115 例（96%）患儿至少有 1 个淋巴结，最常见的是隆突下（69%）、气管旁（64%）和肺门（60%）淋巴结。0-10 岁患儿中，大多数淋巴结短轴直径小于或等于 7mm，年龄较大患儿中可发现最大短轴直径达 10mm 的淋巴结。在患儿中，沿乳腺血管、食管下段、血管前和后纵隔区域淋巴结很少见。
与既往研究相比，纵隔和肺门淋巴结更为常见，这可能与现代多排 CT 检测能力提高有关。在评估儿童胸部淋巴结时，需要考虑到淋巴结的位置和年龄。
正常淋巴结的大小和位置具有重要的诊断意义；
与儿童胸部 CT 相关的信息较少；
提供了儿童纵隔和肺门淋巴结的正常值；
这些正常值有助于识别儿童异常淋巴结。
