腹腔及腹膜后间隙淋巴结结核的多层螺旋CT强化特征

目的研究腹腔及腹膜后间隙淋巴结结核的多层螺旋CT强化特征,以提高该疾病的影像诊断水平。方法收集本院经临床病理证实的腹部淋巴结结核19例,在多层螺旋CT强化图像上,观察受累淋巴结的大小、形态、密度、强化类型、优势解剖分布以及淋巴结外器官病变的强化特征。结果94.7%淋巴结结核呈典型的环状强化,仅5.3%增大的淋巴结呈均匀强化。腹部淋巴结结核常优势地累及肠系膜(73.7%)、门腔间隙(63.2%)、肝十二指肠韧带(57.9%)、肝胃韧带(47.4%)和腹主动脉周围上部淋巴结(47.4%)。9例(47.4%)脾增大,其中5例(26.3%)脾内有多发低密度灶,病灶周边强化;6例(31.5%)腹腔积液;3例(15.8%)大网膜、肠系膜和壁层腹膜广泛结节样增厚。结论结核累及腹腔及腹膜后间隙淋巴结的多层螺旋CT强化具有一定特征。

Peritoneal and Retroperitoneal Lymphatic Tuberculosis:Evaluation with Contrast-enhanced Multi-detector row CT

Objective To clarify the contrast-enhanced multi-detector row (MDCT)features of the peritoneal and retroperitoneal lymphatic tuberculosis so as to improve the imaging diagnosis.Methods MDCT features of abdominal lymphatic tuberculosis in 19 cases comfirmed by pathology were retrospectively evaluated in a blind review for the size,morphology,attenuation,enhancement pattern and anatomic distribution of the affected lymph nodes and extranodal organs.Results Rim enhancement of the affected lymph nodes was seen in 18 patients (94.7%).Tuberculosis commonly involved the lymph nodes in the mesentery(73.7%),portacaval space(63.2%),hepatoduodenal ligament(57.9%),hepatogastric ligament (47.4%) and upper para-aortic region (47.4%).Splenomegaly was seen in 9 cases and with scattered low-density foci in 5 cases,these lesions showed rim enhancement.Seroperitoneum was seen in 6 cases with thickened parietal peritoneum,greater omentum and lesser omentum in 3 cases.Conclusion Peritoneal and retropenitoned lymphatic tuberculosis is of certain MDCT characteristics.