结核性腹膜炎的CT表现及其病理学基础

目的　探讨结核性腹膜炎的CT表现特点及其病理基础。方法　 2 1例经病理和临床证实的结核性腹膜炎病例 ,主要观察( 1)腹水性质及解剖分布 ;( 2 )系膜、网膜、腹膜改变的CT表现形式 ;( 3)淋巴结肿大及其增强情况。结果　 ( 1)腹水 18例 ,高密度腹水 15例 ( >2 0HU) ,3例低密度腹水 ( <2 0HU) ,6例为包裹性积液。 ( 2 )系膜改变为增厚、结节状、污秽状 ,共 2 1例。 ( 3)饼状网膜肿块 5例 ,网膜点条状、污秽样改变 8例。 ( 4 )腹膜增厚 15例 (腹膜光滑 13例 ,腹膜结节 2例 )。 ( 5 )淋巴结肿大 9例 ,7例并见环状强化。结论　腹膜、网膜、系膜的改变伴高密度腹水 ,环状强化的肿大淋巴结 ,常可作出结核性腹膜炎的诊断。

CT Manifestations and Pathologic Basis of Tuberculous Peritonitis

Objective To investigate the characteristic CT appearances and pathologic basis of tuberculous peritonitis(TP).Methods There were 21 cases with TP proved by operation and clinic,following points were mainly observed:(1)Existence,attenuation and anatomic distrubition of ascites.(2)The forms of omentum,mensentery,peritoneal thickening.(3)Enhanced forms of lymphadenopathy.Results CT features included:(1)ascites (total 18),encysted ascites(n=6),hyperdense ascites(n=15,CT value >20 HU),hypodense ascites(n=3,CT value <20 HU).(2)Thickened mensentery with nodular or smudged shadows(n=21).(3)Omental caking(n=5),strand and smudged(n=8).(4)Thickened peritoneum,smoothly(n=13) or nodular(n=2).(5)Lymphadenopathy (n=9),annular enhancement(n=7).Conclusion As peritoneum,mensentery,omental thickened with hyperdense ascites and annular enhancement of lymphadenopathy were showed by CT,usually the diagnosis of tuberculous peritonitis can be made.