Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Clin Radiol. 2012 Sep;67(9):877-83. doi: 10.1016/j.crad.2012.02.006. Epub 2012 Apr 7.
To determine the specific imaging criteria on contrast-enhanced multidetector computed tomography (MDCT) for differentiating between tuberculosis and lymphoma in mediastinal lymph nodes.
The anatomical distribution and enhancement patterns of mediastinal lymph nodes on contrast-enhanced MDCT were reviewed in 37 patients with tuberculosis and 54 patients with lymphoma. Of the patients with lymphoma, 18 had Hodgkin's disease and 36 had non-Hodgkin's lymphoma.
Region 10R was involved more often in tuberculosis than in Hodgkin's disease and non-Hodgkin's lymphoma. Region 6 had a higher tendency to be affected in Hodgkin's disease and non-Hodgkin's lymphoma compared with tuberculosis. Tuberculosis showed peripheral enhancement in 78% of cases, frequently with a multilocular appearance, compared to Hodgkin's disease and non-Hodgkin's lymphoma, which showed peripheral enhancement in only 6 and 3% of cases, respectively. Homogeneous enhancement was more commonly seen in lymphoma (83% for Hodgkin's disease, and 83% for non-Hodgkin's lymphoma) than in tuberculosis (8%). In the determination of tuberculosis, results showed that when a peripheral enhancement pattern was seen, sensitivity was 78%, specificity was 96%, and accuracy was 89%. In the determination of lymphoma, results showed that when a homogeneous enhancement pattern was seen, sensitivity was 83%, specificity was 92%, and accuracy was 87%.
The findings of the present study indicate that specific anatomical distribution and enhancement patterns of lymphadenopathy shown on contrast-enhanced MDCT can be useful in differentiating tuberculosis from lymphoma of mediastinal lymph nodes.
确定对比增强多排螺旋 CT（MDCT）在鉴别纵隔淋巴结结核和淋巴瘤中的具体影像学标准。
回顾性分析 37 例结核患者和 54 例淋巴瘤患者纵隔淋巴结 CT 增强的解剖分布和增强模式。其中，霍奇金病 18 例，非霍奇金淋巴瘤 36 例。
结核组 10R 区受累较霍奇金病和非霍奇金淋巴瘤多见，6 区在霍奇金病和非霍奇金淋巴瘤中受累的倾向高于结核。结核 78%表现为边缘强化，常呈多房性，而霍奇金病和非霍奇金淋巴瘤仅分别有 6%和 3%表现为边缘强化。淋巴瘤（霍奇金病 83%，非霍奇金淋巴瘤 83%）较结核（8%）更常见均匀强化。在诊断结核时，边缘强化模式的敏感性为 78%，特异性为 96%，准确性为 89%；在诊断淋巴瘤时，均匀强化模式的敏感性为 83%，特异性为 92%，准确性为 87%。
本研究结果表明，纵隔淋巴结病变 CT 增强的特定解剖分布和强化模式有助于鉴别结核和淋巴瘤。
