结核性腹膜炎的64层螺旋CT诊断

目的探讨64层螺旋CT对结核性腹膜炎的诊断价值,方法回顾分析经手术、穿刺、病理及临床综合指标且经抗结核治疗、随访症状及影像学检查明显改善者9例,CT检查主要观察：（1）网膜、系膜的增厚形式,（2）腹水的分布及密度,（3）腹腔淋巴结及增强表现。结果结核性腹膜炎的64层螺旋CT表现有：（1）大网膜增厚8例,污迹样增厚7例,饼状大网膜4例,腹膜结节2例;（2）肠系膜受累5例,磨玻璃样改变3例,条索3例;（3）壁层腹膜增厚5例,以均匀增厚为主。上述3种表现可单独存在也可并存。病变腹膜增强扫描均有不同程度的增强;（4）淋巴结肿大4例,其中一例环状强化;（5）小肠改变3例;（6）腹腔积液4例。结论腹部64层CT平扫加增强对发现和诊断渗出性结核腹膜炎具有重要的临床价值。

64 slice spiral CT in the diagnosis of tuberculous peritonitis

Objective ] To investigate the value of 64 slice spiral CT in the diagnosis of tuberculous peritonitis. Methods ] For the analysis of the operation, biopsy, pathology and clinical indicators and after anti tuberculosis treatment, symptoms and imaging examination were obviously improved in 9 cases, CT examination were （1） omental, mesangial thickening form ;（2） the distribution and density of ascites; （3） abdominal lymph nodes and enhanced performance. Resluts ] Of 64 slice spiral CT features of tuberculous peritonitis. （1） in 8 patients with greater omentum, stains like thickening in 7 cases, 4 cases of pie greater omentum, 2 cases with peritoneal nodules; （2） of 5 patients with mesenteric involvement, ground glass opacity in 3 cases, the cable in 3 cases; 5 cases; （3） wall layer of peritoneal thickening, thickening mainly in uniform. The performance of the 3 can exist alone can coexist. Peritoneal lesions enhanced scanning showed different degree; （4） lymph nodes in 4 cases; one case with ring enhancement; （5） the small intestine in 3 cases; （6） of 4 cases of abdominal effusion. Conclusion ] Abdominal enhanced CT scan to detect and has important clinical value in the diagnosis of exudative tuberculosis peritonitis.