螺旋CT显示颈部淋巴结肿大。

Enlarged cervical lymph nodes at helical CT.

作者信息

Steinkamp H J, Hosten N, Richter C, Schedel H, Felix R

机构信息

Department of Radiology, Freie Universitat Berlin, Klinikum Rudolf Virchow/Standort Wedding, Germany.

出版信息

Radiology. 1994 Jun;191(3):795-8. doi: 10.1148/radiology.191.3.8184067.

DOI:10.1148/radiology.191.3.8184067

PMID:8184067

Abstract

PURPOSE

To evaluate criteria for differentiating malignant versus reactive lymph nodes in the head and neck on the basis of findings at helical computed tomography (CT).

MATERIALS AND METHODS

Helical CT scans were evaluated of 70 consecutive patients (46 men and 24 women, aged 20-78 years [mean, 51 years]) with known head and neck tumors and cervical lymph node enlargement. The ratio of the maximal longitudinal to the maximal axial diameter (L/T) was calculated for nodes larger than 8 mm in diameter based on measurements obtained from coronal, paraxial, and sagittal reconstructions.

RESULTS

At histologic examination, 96 of 164 nodes were malignant. Of these, 94 of 96 nodes had an L/T of less than 2 (sensitivity, 97%; specificity, 97%; accuracy, 97% for malignancy). Minimal diameter was more than 8 mm in 83 of 96 nodes (sensitivity, 87%; specificity, 89%; accuracy, 88% for malignancy). Low-attenuation centers and rim enhancement were seen in 75 of 96 nodes (sensitivity, 78%; specificity, 100%; accuracy, 86% for malignancy).

CONCLUSION

The L/T at helical CT provide an accurate assessment of reactive versus malignant nodes in the head and neck.

摘要

目的

基于螺旋计算机断层扫描（CT）的表现，评估头颈部恶性与反应性淋巴结的鉴别标准。

材料与方法

对70例连续患者（46例男性和24例女性，年龄20 - 78岁[平均51岁]）进行螺旋CT扫描，这些患者已知患有头颈部肿瘤且伴有颈部淋巴结肿大。根据从冠状面、旁矢状面和矢状面重建图像上获得的测量值，计算直径大于8 mm的淋巴结的最大纵径与最大横径之比（L/T）。

结果

组织学检查显示，164个淋巴结中有96个为恶性。其中，96个恶性淋巴结中有94个L/T小于2（敏感性97%；特异性97%；诊断恶性的准确性97%）。96个恶性淋巴结中有83个最小直径大于8 mm（敏感性87%；特异性89%；诊断恶性的准确性88%）。96个恶性淋巴结中有75个可见低密度中心和边缘强化（敏感性78%；特异性100%；诊断恶性的准确性86%）。