结核性腹膜炎CT诊断要点分析

Analysis of the Characteristic CT Appearances of Tuberculous Peritonitis

目的:探讨结核性腹膜炎(Tuberculous Peritonitis,TBP)的CT表现特点及其病理基础,提高结核性腹膜炎的CT诊断水平。材料与方法:对28例经病理和临床证实的结核性腹膜炎,分析其术前CT表现,观察了解:腹水的性质及分布;系膜、网膜及腹膜病变的CT表现;肿大淋巴结的平扫及其增强后的特点。结果:腹水25例,占本组病例的89.3%(25/28);系膜改变24例,占本组病例的85.7%(24/28),表现为增厚、结节状、污秽状;网膜改变7例,占本组病例的25.0%(7/28),表现为饼状网膜;腹膜增厚14例,占本组病例的50.0%(14/28);淋巴结肿大6例,占本组病例的21.4%(6/28)。结论:系膜、网膜及腹膜的改变伴高密度腹水,可伴有肿大淋巴结,并结合其合并肺结核或其它脏器结核等表现,常可高度作出结核性腹膜炎的诊断。

Purpose： To investigate the characteristic CT appearances and pathologic basis of tuberculous peritonitis （TBP）. Improve the diagnosis level of tuberculous peritonitis （TBP）. Materials and Methods： The CF imaging of 28 patients with TBP by operation and clinic were analyzed retrospectively. Following points were mainly observed： Existence, attenuation and anatomic distrubition of＇ aseites. Tile forms of omenttun, mesenterium, peritoneum alterant. Plain and enhanced eharacteristicv of lymphaden. Results： The spiral CT images show that 25 of 28 （89.3 % ） 24 of 28 （85.7 % ） with mesenterium alteration, Thickened mesenterium with nodosity or smudged. 10 of 28 （35.7 % ） with omenturn alteration, 14 of 28 （50.0%） with thickened peritoneum, 6 of 28 （21.4%） with lymphadenopathy. Conclusion： The forms of omentum, mesenterium, peritoneum alteration with hyperdense aseites and lymphadenopathy, to integrate clinic with other tubercle disease, usually is help- ful to the diagnosis of TBP.