医学临床研究
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医学临床研究  2020, Vol. 37 Issue (6): 886-888    DOI: 10.3969/j.issn.1671-7171.2020.06.026
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MRI对颈部淋巴结结核诊断准确性及其影响因素分析
陈禄, 唐晨虎, 薛健, 高金辉
南京中医药大学附属南京市中西医结合医院,江苏 南京 210014
Analysis of the Accuracy and Influencing Factors of MRI in the Diagnosis of Cervical Lymph Node Tuberculosis
CHEN Lu, TANG Chen-hu, XUE Jian, et al
Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing 210014
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摘要 目的】 探讨MRI对颈部淋巴结结核诊断的准确性,并分析影响诊断准确率的因素。【方法】 选择2017年2月至2018年5月本院收治的行CT、MRI颈部检查的200例颈部淋巴结结核患者的临床资料,比较两种检查方法诊断的准确性、特异性、灵敏度,并分析影响MRI检查结果准确率的因素。【结果】 MRI扫描显示,淋巴结受累所致干酪样坏死的淋巴结与周围脂肪间隙清晰可辨,并可清晰显示淋巴结病变情况;CT表现为低、等混杂密度影像,边界较为清晰。结核性肉芽组织、淋巴结出现包膜坏死时,MRI、CT影像显示均较明显。MRI对颈部淋巴结结核诊断的准确性为90.00%(180/200),明显高于CT检查的75.00%(150/200),差异有统计学意义(χ2=15.585,P<0.001)。颈部淋巴结结核患者的MRI阳性预测值高于CT诊断,差异有统计学意义(P<0.01);但两种方法诊断的灵敏度、特异度比较,差异无统计学意义(P>0.05)。淋巴结结核多发、直径≥2 cm的患者MRI诊断准确性较高,差异有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,患者的淋巴结结核直径是影响其检查结果准确性的独立危险因素(OR=5.238,P<0.05)。【结论】 MRI对颈部淋巴结结核诊断的准确性较CT高,且诊断的准确性受结节直径大小的影响。
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陈禄
唐晨虎
薛健
高金辉
关键词 结核,淋巴结/诊断磁共振成像    
Abstract:【Objective】To observe the accuracy of MRI in the diagnosis of cervical lymph node tuberculosis, and to analyze the factors affecting the accuracy of diagnosis. 【Methods】From February 2017 to may 2018, the clinical data of 200 patients with cervical lymph node tuberculosis who underwent CT and MRI neck examination were selected to compare the accuracy, specificity and sensitivity of the two methods, and the factors influencing the accuracy of MRI examination results were analyzed.【Results】MRI scan showed that the space between the lymph node and the surrounding fat caused by cheese like necrosis of lymph nodes was clear and recognizable, and the pathological changes of lymph nodes could be clearly displayed; CT showed low and equihybrid density images, with clear boundary. When the tuberculous granulation tissue and lymph node were necrotic, MRI and CT images were obvious. The accuracy of MRI in the diagnosis of cervical lymph node tuberculosis was 90.00% (180/200), which was significantly higher than that of CT in 75.00% (150/200). The difference was statistically significant (χ2=15.585, P<0.001). The positive predictive value of MRI in patients with cervical lymph node tuberculosis was higher than that of CT, the difference was statistically significant (P<0.01), but the difference was not statistically significant (P>0.05). The accuracy of MRI diagnosis was higher in patients with multiple nodal tuberculosis and diameter ≥2 cm (P<0.01). Multivariate logistic regression analysis showed that tuberculous diameter was an independent risk factor (OR=5.238, P<0.05).【Conclusion】 The accuracy of MRI in the diagnosis of cervical lymph node tuberculosis is higher than that of CT, and the accuracy of diagnosis is affected by the diameter of the nodule.
Key wordsTuberculosis,pulmonary    Neck    Magnetic Resonance Imaging
收稿日期: 2019-04-24     
PACS:  R522  
通讯作者: E-mail:787232846@qq.com   
引用本文:   
陈禄, 唐晨虎, 薛健, 高金辉. MRI对颈部淋巴结结核诊断准确性及其影响因素分析[J]. 医学临床研究, 2020, 37(6): 886-888.
CHEN Lu, TANG Chen-hu, XUE Jian, et al. Analysis of the Accuracy and Influencing Factors of MRI in the Diagnosis of Cervical Lymph Node Tuberculosis. JOURNAL OF CLINICAL RESEARCH, 2020, 37(6): 886-888.
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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.06.026     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I6/886
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