高频超声在小儿肠系膜淋巴结炎超声诊断与鉴别诊断中价值.docVIP

高频超声在小儿肠系膜淋巴结炎超声诊断与鉴别诊断中价值 　　doi：10.3969/j.issn.1007-614x.2014.19.71 　　摘 要 目的：探讨高频超声对小儿肠系膜淋巴结炎的诊断价值。方法：对186例年龄3～12岁的小儿肠系膜淋巴结进行检查，对肿大的淋巴结的声像图像及内部血流情况进行回顾性分析。结果：声像图表现：①腹腔内均可探及肿大肠系膜淋巴结，且多位于脐周（87%）及右下腹（78%）；②肿大的肠系膜淋巴结呈椭圆形，边界清晰、完整，中心髓质呈高回声，周围皮质呈低回声，皮髓分界清，纵横比2，无融合；③CDFI显示淋巴结内血流增加，部分见血流呈树枝状由淋巴门处进入，RI 0.5左右；④经抗炎治疗后的超声复查，肿大淋巴结消失或缩小至长径10 mm，短径5 mm，1周～3个月。结论：小儿肠系膜淋巴结炎诊断与鉴别诊断中，高频彩超起着重要的作用，同时结合临床表现及实验室检查，可进一步提高小儿肠系膜淋巴结???的诊断与鉴别诊断价值。高频超声是小儿肠系膜淋巴结炎的首选检查方法。 　　关键词 肠系膜淋巴结炎 高频超声 彩色多普勒血流成像 　　The value of high frequency ultrasound in the diagnosis and differential diagnosis of pediatric mesenteric lymphadenitis 　　Gu Haiyan 　　Ultrasound Department，Binjiang Peoples Hospital of Jiangdu District of Yangzhou City，Jiangsu 225211 　　Abstract Objective：To explore the diagnostic value of high frequency ultrasound in pediatric mesenteric lymphadenitis.Methods：186 cases was 3～12 years old.Their mesenteric lymph nodes were examined.The ultrasound image and internal blood flow condition of enlarged lymph nodes were analyzed retrospectively.Results：Ultrasonographic performance：①abdominal cavity can be detected enlarged mesenteric lymph nodes，and they mainly located in umbilical week（87%） and the right lower abdomen（78%）.②Enlarged mesenteric lymph nodes were oval.The boundary was clear and complete.The center medulla was hyperechogenicity.The cortex around was hypoecho.The peel pulp boundary was clear.The aspect ratio was more than 2.There was amixis.③CDFI displayed that the blood flow of lymph node was increased，see blood dendritic into the lymph door， RI was about 0.5.④After anti-inflammatory therapy for ultrasonic review，the swollen lymph node disappeared or reduced to long diameter less than 10 mm，short diameter less than 5 mm，1 week to 3 months.Conclusion：High frequency ultrasound plays an important role in the diagnosis and differential diagnosis of pediatric mesenteric lymphadenitis.It combined with clinical manifestations and laboratory examination，which can further improve the value of