【摘要】 目的：探讨组织细胞坏死性淋巴结炎CT及PET-CT表现及临床特点，旨在提高对该病的诊断水平。方法：回顾性分析12例经组织病理学诊断为组织细胞坏死性淋巴结炎的影像资料及临床资料，男4例，女8例，年龄13～47岁，平均（28.75±12.02）岁，所有病例均接受了CT检查，3例病例进行CT强化扫描，3例病例进行全身18F-FDG PET-CT检查。结果：（1）分布位置：12例病例表现为颈部淋巴结增大，集中分布在颈部Ⅱ～Ⅴ区，2例伴有腋窝淋巴结增大，2例伴腹盆部淋巴结增大（为PET-CT检查发现）。（2）淋巴结形状（225个淋巴结）：椭圆形淋巴结占43.7%，圆形淋巴结占39.1%，长条状淋巴结占17.2%。（3）淋巴结的短径分布情况（225个淋巴结），多数在10mm以下。（4）淋巴结强化方式：多数为均匀强化，少部分出现环形强化，动脉期CT值约为（74.66±13.45）HU，静脉期CT值约为（92.72±15.76）HU，延迟强化显著。（5） 50组淋巴结的18F-FDG代谢情况：淋巴结的最大标准摄取值（SUVmax）集中分布在5～10，平均值为6.85±2.76，且SUVmax值与淋巴结短径具有正相关性。结论：组织坏死性淋巴结炎好发于颈部，CT及PET-CT检查对组织细胞坏死性淋巴结炎的诊断具有一定的价值，最终确诊依赖于临床资料、影像及病理的综合分析。更多还原

【Abstract】 Purpose: To investigate the CT and PET-CT manifestations and clinical features of histiocytic necrotizing lymphadenitis(HNL) in order to improve the diagnostic level of this disease.Methods: The imaging and clinical data of 12 cases of histopathologically diagnosed HNL, including 4 males and 8 females, aged 13-47 years,with an average age of(28.75±12.024) years, were retrospectively analyzed. All cases underwent CT examination,and 3 cases underwent enhanced CT scanning. Whole body 18F-FDG PET-CT examination was performed in 3 cases.Results:(1) Distribution: twelve cases showed enlarged cervical lymph nodes, concentrated in the neck region Ⅱ-Ⅴ,two cases were accompanied by enlarged axillary lymph nodes, and two cases were accompanied by enlarged abdominal and pelvic lymph nodes(PET-CT examination).(2) Shape of lymph nodes(225 lymph nodes): oval lymph nodes were accounted for 43.7%, round lymph nodes accounted for 39.1%, long strip lymph nodes accounted for 17.2%.(3) Short diameter distribution of lymph nodes(225 lymph nodes): most of which were less than 10 mm.(4)Lymph node enhancement pattern: most of them were uniform enhancement, and a few of them were annular enhancement. CT values of them in arterial phase was about(74.66±13.45) HU, and those in venous phase was about(92.72±15.76) HU, which indicated significant delayed enhancement.(5)18F-FDG metabolism of the 50 groups of lymph nodes: the maximum standard uptake value(SUVmax) of lymph nodes was between 5 and 10, with an average value of 6.85±2.76, and SUVmax was positively correlated with the short diameter of lymph nodes.Conclusion: Tissue necrotizing lymphadenitis usually occurs in the neck. CT and PET-CT examination have certain value in the diagnosis of tissue necrotizing lymphadenitis, and the final diagnosis depends on the comprehensive analysis of clinical data, imaging and pathology results.更多还原