腹腔结核的CT表现

目的评价CT诊断腹腔结核的价值。方法回顾性分析经手术病理或抗痨治疗确诊的腹腔结核16例CT表现,其中男8例,女8例。年龄20～66岁,平均36.4岁。结果腹腔淋巴结肿大(n=11),肠系膜肿块(n=6),腹水(n=6,多为限制性),网膜增厚(n=7),肠壁增厚(n=6),胸水(n=2),胰腺结节(n=1)。腹腔淋巴结肿大(以肠系膜、胰周淋巴结为主),主要表现为因中央干酪样坏死而呈环形或多房样强化,并有部分淋巴结钙化,且腹腔淋巴结受累程度明显重于腹膜后间隙淋巴结。结核性腹膜炎时腹水密度较高,系膜、网膜上有斑片状及结节状病灶,肠曲粘连固定。结论密切结合临床、实验室检查及CT表现,有望提高腹腔结核诊断准确性。

CT Features of Abdominal Tuberculosis

Objective To evaluate the value of computed tomography(CT)in diagnosing abdominal tuberculosis.Methods CT features of abdominal tuberculosis proven histopathologically or by antituberculous therapy in 16 cases were retrospectively analysed.There were 8 men and 8 women,the age ranged from 20 to 66 years,mean age was 36.4 years.Results The most common CT features of abdominal tuberculosis were:lymphadenectasis(n=11),mesenteric masses(n=6),ascites(n=6,all were loculated),omental thickening(n=7),bowel wall thickening(n=6),pleural fluid(n=2),and pancreatic involvement(n=1).Tuberculous lymphadenosis(mainly the mesentery and peripancreatic lymph nodes involved)had typical CT findings including circular or multilocular enhancement,calcification of lymph nodes,abdominal lymph nodes involved more than that of retroperitoneum and peritonitis(high dense ascites,patchy or nodular lesions in the mesentery and omentum,and intestinal adhesion).Conclusion CT findings in combination with clinical symptoms and laboratory test can improve the diagnosis of abdominal tuberculosis.