脾结核的CT征象

目的 评价脾结核的CT表现在诊断中的价值。方法 对11例脾结核的影像资料和临床资料进行回顾性分析。结合有关文献进行了深入讨论。结果 9例CT表现为脾内多发性大小不等的类圆形，低密度灶，8例伴有脾门，胰周及邻近大血管周围多数低密度结节影，少数有融合，增强扫描脾，胰，肝及肾等脏器内病变无强化，腹腔淋巴结表现为周边环状强化而中央无强化，仅1例表现为肝，脾，腹腔多发钙化影，1例肝，脾内多发钙化，结论 脾结核通常不是孤立性病变，是全身结核的一部分，脾脏病灶，CT表现为脾内单发或多发不被强化的低密度区，钙化，肝脾肿大等，影像学表现不具有特异性，但是淋巴结结核的CT表现具有特征性，发现脾外结核的证据常能确立诊断。

CT findings of splenic tuberculosis

Objective To explore the computed tomography(CT) findings of splenic tuberculosis(ST) and their role in the diagnosis. Methods CT features in 11 patients with ST proven by laparoscopy and pathology from 1995 to 2000 were retrospectively reviewed. Results Splenic multinodular lesions were found in 9 cases,splenic masses in 2 cases, calcifications in 2 cases, and diffuse liver and spleen enlargement in all. The masses and nodes showed low attenuation or lower soft tissue attenuation when enhanced. Low attenuation splenic and /or adenopathies in splenic hilus, hepatic hilus and retroperitoneal region were found in 8 cases, and peripheral rim enhancement were found in 6/8 cases when contrast material were administered. Pancreatic low attenuation lesions were found in 3 cases, and hepatic multinodular low attenuation lesions in 3 cases and defuse calcified spots in 1 case. Conclusion ST has variable spectrum of CT findings, including splenic focal low attenuation lesions or masses, multiple small low attenuation splenic nodules without enhancement, splenic calcifications, and diffuse enlargement of spleen, but ST usually appears as low attenuation with unenhanced splenic lesions or masses. Low attenuation adenopathies with peripheral rim enhancement in splenic hilus, hepatic hilus and retroperitoneal region and other data of disseminated tuberculosis are ancillary findings that should support a diagnosis of ST.