肠系膜结核的多排螺旋CT特征探讨

Spiral CT Features of Mesenteric Tuberculosis

目的探讨肠系膜结核的螺旋CT表现特征。方法回顾性分析18例CT扫描资料和临床资料完整的肠系膜结核病例,其中经手术病理证实8例;单纯病理证实3例,经临床综合指标及抗痨治疗随访显效而诊断者7例。着重观察小肠系膜、横结肠系膜病变的CT表现特征。结果①系膜结核性淋巴结炎9例:小肠系膜和横结肠系膜密度增高8例;血管增粗伴血管边缘模糊1例;系膜淋巴结增大9例,其中环状强化4例。②系膜结核性淋巴结炎伴结核性系膜炎9例:肠系膜密度增高9例;肠系膜结节影和索条影8例,1例伴局灶性团块影;系膜呈团块状1例;血管增粗6例,伴或不伴血管边缘不清;系膜淋巴结增大9例,其中环状强化2例。③18例中,腹主动脉周围淋巴结增大9例,环状强化5例,其中2例融合呈团块状。结论系膜结核主要CT表现为系膜淋巴结增大,伴环状和/或均匀强化;系膜密度增高,系膜结节影、索条影、团块影等。MDCT可全面显示系膜结核的解剖细节。

Objective To study the multi-detector computed tomography （MDCT） findings of mesenteric tuberculosis. Methods The Authors retrospectively reviewed 18 cases with mesenteric tuberculosis, of which 8 cases were proved by surgery and pathology, 3 cases were proved by pure pathology, 7 cases were proved by clinical and laboratory＇ findings. Emphasis was placed on helical CT features of the small bowel mesentery and the transverse mesocolon. Results The main CT findings of mesenteric tuberculosis were revealed as follows ：（1）Mesenteric tuberculous lymphadenopathy ： 8 cases showed increase in density of mesenteric fat, and 1 case showed engorgement of the mesenteric vessels accompany with poorly-defined margin. Enlarged mesenteric lymph node was showed in 9 cases, of which 4 cases showed ring-like enhanced. （2）Mesenteric tuberculous lymphadenopathy accompany with mesenteritis： increase in density of mesenteric fat, 9 cases, and mesenteric stranding and nodule shadow, 8 cases. Engorgement of the mesenteric vessels, 6 cases, accompany with poorly-defined or well-defined margin. Enlarged mesenteric lymph node was showed in 9 cases, of which 2 cases showed ring-like enhanced. （3）Among 18 cases, enlarged lymph nodes around ＇abdominal aorta were showed in 9 cases, 4 cases showed ring-like enhanced. Conclusion The main CT fingdings of mesenteric tuberculosis may be concluded as the following： enlarged mesenteric lymph node accompany with ring-like enhancement, increase in density of mesenteric fat, thickened mesentery with stranding, nodule shadow, and mass. MDCT can demonstrate its anatomy details.