小儿结核病计算机断层扫描中的纵隔淋巴结肿大

Mediastinal lymphadenopathy in pediatric tuberculosis in computed tomography scan.

作者信息

Mehrain Payam, Moghaddam Amin Momeni, Tavakol Elham, Amini Afshin, Moghimi Mehrdad, Kabir Ali, Velayati Ali Akbar

机构信息

Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Int J Mycobacteriol. 2016 Dec;5 Suppl 1:S242-S243. doi: 10.1016/j.ijmyco.2016.11.019. Epub 2016 Nov 25.

DOI:10.1016/j.ijmyco.2016.11.019

PMID:28043582

Abstract

BACKGROUND/OBJECTIVES: Pediatric tuberculosis is usually a primary infection presenting mainly as mediastinal or hilar adenopathy in computed tomography (CT) scan. In this study, we study the distribution and other CT scan characteristics of mediastinal lymphadenopathy in childhood tuberculosis.

METHODS

Chest CT scans of 75 cases of pediatric tuberculosis at Masih Daneshvari Hospital in Tehran, Iran, from 2009 to 2013 were studied regarding characteristics of mediastinal lymphadenopathy.

RESULTS

Mean±standard deviation age of cases was 11.2±4.6years. Lymphadenopathy (mediastinal/hilar) was detected in 94.7% of cases. Most of the lymphadenopathies were located in the lower paratracheal (81.7%), upper paratracheal (69.1%), hilar (53.5%), and subcarinal (47.9%) stations. Perilymph node fatty stranding, lymphadenopathy conglomeration, bronchial pressure by the lymph nodes, and lymph node calcification were noted in 74.6%, 52.11%, 4.23%, and 5.6% of cases, respectively. Bilateral, right, and left lung parenchymal involvement were reported in 45%, 25%, and 8% of cases, respectively. Lung parenchymal involvement was significantly correlated with lymphadenopathies in subcarinal (p<0.001), hilar (p<0.001), subaortic (p=0.03), lower paratracheal (p=0.037), and axillary (p=0.006) stations. Right- and left-sided pleural effusions were observed in 12.7% and 7% of cases, respectively.

CONCLUSION

Attention to distribution and characteristics of mediastinal lymphadenopathy can help differentiate tuberculosis from other causes of pediatric mediastinal lymphadenopathy.

摘要

背景/目的：儿童结核病通常为原发性感染，在计算机断层扫描（CT）中主要表现为纵隔或肺门淋巴结肿大。在本研究中，我们研究了儿童结核病纵隔淋巴结肿大的分布及其他CT扫描特征。

方法

对2009年至2013年期间伊朗德黑兰马西赫·达内什瓦里医院75例儿童结核病患者的胸部CT扫描进行纵隔淋巴结肿大特征研究。

结果

病例的平均年龄±标准差为11.2±4.6岁。94.7%的病例检测到淋巴结肿大（纵隔/肺门）。大多数淋巴结肿大位于气管旁下部（81.7%）、气管旁上部（69.1%）、肺门（53.5%）和隆突下（47.9%）区域。分别有74.6%、52.11%、4.23%和5.6%的病例出现淋巴结周围脂肪条索影、淋巴结融合、淋巴结压迫支气管和淋巴结钙化。分别有45%、25%和8%的病例报告有双侧、右侧和左侧肺实质受累。肺实质受累与隆突下（p<0.001）、肺门（p<0.001）、主动脉弓下（p=0.03）、气管旁下部（p=0.037）和腋窝（p=0.006）区域的淋巴结肿大显著相关。分别有12.7%和7%的病例观察到右侧和左侧胸腔积液。