目的评价成人纵隔淋巴结结核CT增强表现及其病理对照观察。方法对39例经过手术、纵隔镜、穿刺活检证实的纵隔淋巴结结核患者共180个淋巴结进行影像学分析,其中男20例,女19例,年龄16～67岁,中位年龄26岁。所有病例均做CT增强扫描。结果根据病灶强化形态学特征分为5种强化类型:(1)不均匀强化占28.3%(51个),病灶最大直径4.5cm;(2)环形强化占26.1%(47个);(3)均匀强化占25.0%(45个);(4)无明显强化占14.4%(26个);(5)分隔样强化占6.11%(11个)。病理观察,淋巴结强化类型与病灶实质内含血管的肉芽组织和干酪坏死灶的分布密切相关。39例淋巴结结核病例中28例(71.8%)强化是以2种或2种以上形式联合存在,其余11例(28.2%)强化是以单一形式为表现。结论直径在1.0～<2.0cm大小的淋巴结结核依次以均匀强化、无强化、不均匀强化和环形强化为主要表现;直径≥2.0cm的淋巴结结核依次以不均匀强化、环形强化、均匀强化和无强化为主要表现。当淋巴结环形强化、分隔样强化时应考虑淋巴结结核的可能。 Objective To evaluate the enhanced CT findings and pathological findings of mediastinal lymph node tuberculosis in adults. Methods A total of 180 lymph nodes from 39 patients with mediastinal lymph node tuberculosis confirmed by operation, mediastinoscopy and biopsy were analyzed. There were 20 males and 19 females, aged 16-67 years with a median age of 26 years. All cases were done CT enhanced scan. The results were divided into five types based on the morphological characteristics of lesions: (1) uneven enhancement accounted for 28.3% (51), the maximum diameter of lesions was 4.5 cm; (2) annular enhancement accounted for 26.1% (47); (3) Uniform enhancement accounted for 25.0% (45); (4) No significant enhancement accounted for 14.4% (26); (5) Separated like enhancement accounted for 6.11% (11). Pathological observation, type of lymph node enhancement and vascular parenchyma vascular lesions are closely related to the distribution of cheese necrosis. Forty-eight cases (71.8%) of 39 cases of lymph node tuberculosis were fortified in two or more forms, and the remaining 11 cases (28.2%) were enhanced in a single form. Conclusion The nodules of lymph nodes of 1.0 ~ <2.0cm in diameter followed by uniform enhancement, no enhancement, inhomogeneous enhancement and annular enhancement. The nodules with diameter≥2.0cm followed by inhomogeneous enhancement, circular enhancement, uniform enhancement and no Strengthen as the main performance. When the lymph nodes strengthen the ring, separation should be taken into account the possibility of tuberculosis.