螺旋CT对脾脏结核的诊断价值

目的探讨螺旋CT对脾脏结核的诊断价值。方法对9例经手术病理证实或抗结核治愈的脾脏结核CT表现进行回顾性分析,并结合相关文献进行讨论。结果 9例中,6例表现为脾脏内单发或多发大小不等的结节状、斑点状低密度影,边界清或不清,增强扫描病灶内部无强化,7例伴有其他脏器结核,5例伴有腹膜后及肝、脾门区淋巴结肿大或钙化,增强扫描淋巴结呈环状强化或轻度均匀强化,2例肝脾内见多发钙化灶。结论脾脏结核多是全身结核的一部分。脾脏内单发或多发无强化病灶及钙化是脾脏结核的主要CT征象,但不具有特异性。而淋巴结结核的CT表现具有一定的特征性,因此发现脾外结核的证据对脾脏结核的诊断有较大的帮助,螺旋CT为发现脾脏结核较好的检查方法。

Value of spiral CT in the diagnosis of tuberculosis of spleen

Objective To evaluate the value of spiral CT in diagnosis of tuberculosis of spleen. Methods CT findings of 9 cases with tuberculosis of spleen proved by pathology or cured after anti-tuberculosis were retrospective analyzed comparing with related literatures. Results In total 9 cases,solitary or mutiple and nodose or stippled low-density shadows with unequal size and limpid or undefined verge was showed in 6 cases,no enhancement effect was found in them.7 cases with other organ tuberculosis,5 cases with lymphadenectasis or lymph node calcification in retroperitoneal space or porta hepatis or hilum of spleen,enhancement scanning for lymphaden showed that the enhanced ring or mild well-distributed enhancement effect,2 cases with multiple calcifications in spleen. Conclusion Tuberculosis of spleen is often the part of systemic tuberculosis.Solitary or multiple low-density shadows without enhancement effect and calcification are the main features of tuberculosis of spleen,but also no specificity.The CT findings of lymphaden tuberculosis are characteristic.The findings of extra-splenic tuberculosis will support a diagnosis of tuberculosis of spleen.Spiral CT is a feasible method for diagnosis of tuberculosis of spleen.