Ying M, Ahuja A T, Evans R, King W, Metreweli C
Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
J Clin Ultrasound. 1998 Oct;26(8):383-9. doi: 10.1002/(sici)1097-0096(199810)26:8<383::aid-jcu2>3.0.co;2-e.
Clinical examination alone cannot differentiate between cervical tuberculous lymphadenitis and cervical nodal metastases from non-head and neck (NHN) carcinomas because the distributions of involved lymph nodes are similar. We evaluated the sonographic features of cervical lymph nodes that could be used to differentiate between the 2 categories of nodes.
We retrospectively reviewed sonograms of abnormal cervical lymph nodes in 47 patients with proven cervical tuberculous lymphadenitis and in 22 patients with proven nodal metastases from NHN carcinomas.
Abnormal nodes in tuberculous lymphadenitis and nodal metastases from NHN carcinomas were commonly found in the supraclavicular fossa (15% and 38%, respectively) and the posterior triangle (70% and 41%, respectively). Statistically significant (p < 0.05) features for differential diagnosis were lymph nodes' longest diameter, echogenicity, short-to-long axis ratio, appearance of surrounding soft tissues, and presence of intranodal cystic necrosis, matting, and posterior enhancement. Nodal size, echogenicity, presence of an echogenic hilum, calcification, coagulation necrosis, and sharpness of borders helped in identifying the abnormal lymph nodes.
Sonographic features that helped to differentiate between the 2 categories of nodes were shape, edema of surrounding soft tissue, homogeneity, intranodal cystic necrosis, matting, and posterior enhancement.
仅通过临床检查无法区分颈部结核性淋巴结炎与非头颈部（NHN）癌的颈部淋巴结转移，因为受累淋巴结的分布相似。我们评估了可用于区分这两类淋巴结的颈部淋巴结超声特征。
我们回顾性分析了47例经证实为颈部结核性淋巴结炎患者和22例经证实为NHN癌淋巴结转移患者的异常颈部淋巴结超声图像。
结核性淋巴结炎和NHN癌淋巴结转移的异常淋巴结常见于锁骨上窝（分别为15%和38%）和后三角区（分别为70%和41%）。具有统计学意义（p < 0.05）的鉴别诊断特征包括淋巴结的最长径、回声、短轴与长轴比值、周围软组织表现以及结内囊性坏死、融合和后方增强的存在。淋巴结大小、回声、强回声门的存在、钙化、凝固性坏死和边界清晰度有助于识别异常淋巴结。
有助于区分这两类淋巴结的超声特征包括形态、周围软组织水肿、均匀性、结内囊性坏死、融合和后方增强。
