摘要
目的建立成年国人中上腹淋巴结大小正常CT观察标准;探讨影响中上腹正常淋巴结多层螺旋CT观察的因素。资料与方法排除可能引起腹部淋巴结增大的因素,120例行16层螺旋CT腹部增强扫描的成年人纳入本研究。使用工作站,分别采用两种窗技术对中上腹淋巴结的大小、数目及出现率等进行观察测量。结果采用窗宽350HU,窗位30HU观察,上腹部9个部位淋巴结最大短径上限分别为:肝胃韧带6.1mm,门腔间隙8.2mm,胃结肠韧带3.8mm,脾胃韧带2.4mm,腹腔动脉周围6.3mm,肠系膜血管周围6.5mm,膈脚后6.3mm,腹主动脉周围上部6.9mm,腹主动脉周围下部9.8mm。不同窗技术条件对腹部淋巴结的观察有影响,窗a(窗宽350HU,窗位30HU)淋巴结显示率及其最大短轴上限值大于窗b(窗宽200HU,窗位60HU)。腹部脂肪量对淋巴结的显示率有影响,但当腹部脂肪量达到一定量后,显示率并不随脂肪量的增加而升高。结论上腹部淋巴结最大短径上限按部位有所不同,腹膜后淋巴结有从上到下逐渐增大的趋势。观察时采用的窗条件对淋巴结正常上限值测量及显示率有影响。观察个体腹部脂肪量对腹部淋巴结在CT观察时显示率有影响。
Objective To establish the site specific criteria and to probe into the factors influencing the display of the normal lymph nodes in upper and middle abdomen on MDCT scanning. Materials and Methods MDCT scans of 120 adults （age ranged from 15 to 65 years old）, whose normal status of abdominal lymph nodes were identified with carefully physical examination, laboratory testing, history inquiring and CT scan finding, were performed with bolus intravenous contrast enhancement and observed on workstation screen with two different window techniques. Measurement of maximum short axis diameter （MSAD） and maximum long axis diameter （MLAD） of the largest node in nine sites of upper and middle abdomen, was performed using the tool provided by software of MDCT workstation. Upper limit （ P97.5 ） for normal nodal size and number was estimated with the statistic method of frequency table. Results （ 1 ） Observing with window 1 （window width ： 350 HUT, window level ： 30 HUT）, the lymph nodes MSAD upper limit of nine sites on MDCT contrast enhancement scanning were gastrohepatic ligament 6.1 mm, portacaval space 8.2 mm, gastrocolic ligament 3.8 mm, gastrosplenic ligament 2.4 mm, celiac 6.3 mm, superior mesenteric 6.5 mm, retrocrural 6.3 mm, upper paraaortic area 6.9 mm and lower paraaortic area 9.8 mm respectively. The displaying ratio and MSAD upper limit of each location observed with windowl was higher than window 2 （width： 200 HUT, level： 60 HUT）, the difference had statistic significance. （2） The displaying ratios of lymph nodes on CT scanning were higher in the patients with abundant and medium abdominal fat than that with little abdominal fat. The difference had statistic significance. The displaying ratios of maximum short axis diameter of lymph nodes by window a was higher than that by window b. Conclusion （ 1 ） Depending on the locations of lymph nodes, the upper limits of MSAD in upper and middle abdomen on MDCT were varies. The measurement value and displaying ratio of lymph
出处
《临床放射学杂志》
CSCD
北大核心
2006年第9期843-848,共6页
Journal of Clinical Radiology
