结核性与癌性腹膜炎的CT鉴别诊断

目的：探讨结核性腹膜炎（ＴＰ） 与癌性腹膜炎（ ＣＰ） 的ＣＴ 鉴别诊断。材料与方法：搜集经手术病理及临床证实的ＴＰ１２ 例及经手术及病理证实的３４ 例ＣＰ 进行分析。结果：（１） ＴＰ 多表现为少量腹水（７／１０） ，高密度腹水（７／１０） ，ＣＰ常为大量腹水（２２／２９） ；（２） ＴＰ 壁腹膜多为光滑增厚（７／８） ，ＣＰ 为结节状增厚（２４／２４） ；（３） 肠系膜改变伴有环状增强的肿大淋巴结影为ＴＰ 的特征；（４） 大网膜饼形增厚多见于ＣＰ（８／３４） ，但ＴＰ 也可有此种表现（１／１２） ；（５） ＴＰ 液体局限性聚集常有囊壁，ＣＰ 囊状转移多无囊壁且伴肝脾外缘外压性改变。结论：ＣＴ 是鉴别ＴＰ 与ＣＰ 一较好的检查方法。

CT Differential Diagnosis between Tuberculous Peritonitis and Cancerous Peritonitis

Purpose: To evaluate the value of CT differential diagnosis between tuberculous peritonitis (TP) and cancerous peritonitis (CP). Materials and Mathods: 12 cases of TP confirmed pathologically or clinically and 34 cases of CP confirmed pathologically were analysed. Results: (1)A few amount of ascites (7/10) and high density ascites (7/10) were often present in cases of TP, a large amount of ascites (22/29) was often present in cases of CP; (2)Thickened parietal peritoneum with smooth surface was often seen in cases of TP (7/8) and the thickened parietal peritoneum with nodular surface often seen in cases of CP (24/24); (3) Ring like enhancement of enlarged lymphonodus in the cases of mesenteric involvement was the characteristic feature of TP; (4) Omental cakes were often seen in cases of CP (8/34) and occassionally in case of TP (1/12); (5) Local liquid accumulation with capsule was seen in cases of TP and cystic metastasis with no capsule in cases of CP. Conclusion: CT examination is a better method for distinguishing TP from CP.