發(fā)布時間：2018-05-18 17:45

  本文選題：淋巴瘤 + 兒童��； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的通過對72例惡性淋巴瘤患兒臨床特點、超聲表現(xiàn)以及誤診原因分析,提高超聲醫(yī)師對兒童淋巴瘤的認識,以便提高經(jīng)超聲檢查發(fā)現(xiàn)淋巴瘤的可行性。方法收集32超聲影像學誤診但經(jīng)病理證實的兒童淋巴瘤病例,同期收集40例超聲首診診斷正確的兒童淋巴瘤資料,整理其一般資料,包括患兒年齡、性別、超聲檢查結(jié)果、臨床特征等資料并進行統(tǒng)計分析。結(jié)果兒童淋巴瘤的超聲表現(xiàn):(1)頸部包塊表現(xiàn)為異常腫大的一個或多個淋巴結(jié),長短徑比值L/S2,多呈串珠狀或融合狀,邊界大多較整齊清晰,淋巴結(jié)門結(jié)構(gòu)消失;(2)內(nèi)部回聲相對均勻,呈極低回聲或中低回聲,中低回聲內(nèi)可見到似纖維束樣細線狀強回聲,無鈣化及液化;(3)彩色多普勒血流顯像(CDFI)呈Ⅱ~Ⅲ級血流�？v隔淋巴瘤超聲表現(xiàn):前上縱隔腫物超聲表現(xiàn)為融合狀不規(guī)則低回聲,與胸腺關(guān)系密切,內(nèi)呈相對均勻的極低回聲,無鈣化及液化,CDFI:內(nèi)可見到點狀血流。前中縱隔腫物超聲表現(xiàn)為低回聲腫塊,邊界清楚,內(nèi)可見彌漫點狀強回聲,CDFI:可見邊緣血流信號。腸道淋巴瘤的超聲表現(xiàn):(1)腸壁增厚型4例(4/11,36.3%):表現(xiàn)為受累腸壁向心性、環(huán)周全壁均勻或不均勻增厚(約12~26mm),層次結(jié)構(gòu)消失,呈較均勻低回聲。(2)腫塊型6例(6/11,54.5%),表現(xiàn)為腹腔腸套疊聲像圖,套入部腸管壁可見低回聲或極低回聲腫塊,形態(tài)不規(guī)則,CDFI:可見少到中等血流信號。(3)腸管夾雜在條狀低回聲間,腸管壁層次可辨認,部分腸管壁略增厚,發(fā)現(xiàn)中等量腹腔積液。結(jié)論1兒童淋巴瘤絕大多數(shù)為NHL,以頸部淋巴結(jié)及腸管受累較多見。2當超聲表現(xiàn)為兒童不明原因的淋巴結(jié)腫大、腸套疊、腸根阻、腹腔腫塊、縱隔腫塊等聲像圖時需考慮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，

本文編號：1906593