儿童恶性淋巴瘤的超声表现及误诊分析

发布时间：2018-05-18 17:45

  本文选题：淋巴瘤 + 儿童　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的通过对72例恶性淋巴瘤患儿临床特点、超声表现以及误诊原因分析,提高超声医师对儿童淋巴瘤的认识,以便提高经超声检查发现淋巴瘤的可行性。方法收集32超声影像学误诊但经病理证实的儿童淋巴瘤病例,同期收集40例超声首诊诊断正确的儿童淋巴瘤资料,整理其一般资料,包括患儿年龄、性别、超声检查结果、临床特征等资料并进行统计分析。结果儿童淋巴瘤的超声表现:(1)颈部包块表现为异常肿大的一个或多个淋巴结,长短径比值L/S2,多呈串珠状或融合状,边界大多较整齐清晰,淋巴结门结构消失;(2)内部回声相对均匀,呈极低回声或中低回声,中低回声内可见到似纤维束样细线状强回声,无钙化及液化;(3)彩色多普勒血流显像(CDFI)呈Ⅱ~Ⅲ级血流。纵隔淋巴瘤超声表现:前上纵隔肿物超声表现为融合状不规则低回声,与胸腺关系密切,内呈相对均匀的极低回声,无钙化及液化,CDFI:内可见到点状血流。前中纵隔肿物超声表现为低回声肿块,边界清楚,内可见弥漫点状强回声,CDFI:可见边缘血流信号。肠道淋巴瘤的超声表现:(1)肠壁增厚型4例(4/11,36.3%):表现为受累肠壁向心性、环周全壁均匀或不均匀增厚(约12~26mm),层次结构消失,呈较均匀低回声。(2)肿块型6例(6/11,54.5%),表现为腹腔肠套叠声像图,套入部肠管壁可见低回声或极低回声肿块,形态不规则,CDFI:可见少到中等血流信号。(3)肠管夹杂在条状低回声间,肠管壁层次可辨认,部分肠管壁略增厚,发现中等量腹腔积液。结论1儿童淋巴瘤绝大多数为NHL,以颈部淋巴结及肠管受累较多见。2当超声表现为儿童不明原因的淋巴结肿大、肠套叠、肠根阻、腹腔肿块、纵隔肿块等声像图时需考虑到淋巴瘤病的可能性。
[Abstract]:Objective to improve the recognition of children's lymphoma by analyzing the clinical features, ultrasonic manifestations and causes of misdiagnosis in 72 children with malignant lymphoma, so as to improve the feasibility of detecting lymphoma by ultrasound. Methods 32 cases of children's lymphoma misdiagnosed by ultrasonography but confirmed by pathology were collected, and 40 cases of children's lymphoma diagnosed correctly by ultrasound were collected at the same time, and the general data, including age, sex and results of ultrasound, were collected. Clinical features and other data were analyzed statistically. Results in children's lymphoma, the cervical mass presented as one or more lymph nodes with abnormal swelling. The ratio of length to diameter was L / S2, most of them were beaded or fused, and the boundaries were mostly neat and clear. The internal echo of lymph node hilum disappearing was relatively homogeneous, showing very low echo or low echo. In the middle and low echo, the fibrous bundles like thin line strong echo and no calcification and liquefaction were observed. CDFI) showed grade 鈪，

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